Waldo County 4-H Program Impact Form
Submit: Either as you experience success or an annual report by the first Tuesday in September
Full Name Email Phone Adopt Healthy Lifestyle Practices Action 1: Adopt the USDA dietary guidelines and the food guide pyramid. How many youth in your 4-H club, group or family used the the dietary guidelines and the food guide pyramid during this year? Give examples of what happened or is happening. Action 2: Assume personal responsibility for health. How many youth in your 4-H club, group or family assumed personal responsibility for health during this year? Give examples of what happened or is happening. Action 3: Handle animals safely How many youth in your 4-H club, group or family handled animals safely during this year? Give examples of what happened or is happening. Action 4: Integrate regular physical activity into daily life How many youth in your 4-H club, group or family integrated regular physical activity into daily life during this year? Give examples of what happened or is happening. Apply Science and Technology Skills Action 1: Conduct community service or outreach using science and technology skills. How many youth in your 4-H club, group or family conducted community service or outreach using science and technology skills during this year? Give examples of what happened or is happening. Become Responsible and Involved Citizens Action 1: Engage positively in their community How many youth in your 4-H club, group or family engaged positively in their community during this 4-H year? Give examples of what happened or is happening. Action 2: Participate in leadership roles How many youth in your 4-H club, group or family participated in leadership roles during this 4-H year? Give examples of what happened or is happening. 4-H Success or Impact (200 words or less)
Adopt Healthy Lifestyle Practices
Action 1: Adopt the USDA dietary guidelines and the food guide pyramid.
How many youth in your 4-H club, group or family used the the dietary guidelines and the food guide pyramid during this year?
Give examples of what happened or is happening.
Action 2: Assume personal responsibility for health.
How many youth in your 4-H club, group or family assumed personal responsibility for health during this year? Give examples of what happened or is happening.
How many youth in your 4-H club, group or family assumed personal responsibility for health during this year?
Action 3: Handle animals safely
How many youth in your 4-H club, group or family handled animals safely during this year? Give examples of what happened or is happening.
How many youth in your 4-H club, group or family handled animals safely during this year?
Action 4: Integrate regular physical activity into daily life
How many youth in your 4-H club, group or family integrated regular physical activity into daily life during this year? Give examples of what happened or is happening.
How many youth in your 4-H club, group or family integrated regular physical activity into daily life during this year?
Apply Science and Technology Skills
Action 1: Conduct community service or outreach using science and technology skills.
How many youth in your 4-H club, group or family conducted community service or outreach using science and technology skills during this year? Give examples of what happened or is happening. Become Responsible and Involved Citizens
How many youth in your 4-H club, group or family conducted community service or outreach using science and technology skills during this year?
Become Responsible and Involved Citizens
Action 1: Engage positively in their community
How many youth in your 4-H club, group or family engaged positively in their community during this 4-H year? Give examples of what happened or is happening.
How many youth in your 4-H club, group or family engaged positively in their community during this 4-H year?
Action 2: Participate in leadership roles
How many youth in your 4-H club, group or family participated in leadership roles during this 4-H year? Give examples of what happened or is happening.
How many youth in your 4-H club, group or family participated in leadership roles during this 4-H year?
4-H Success or Impact (200 words or less)