BRICE BENDER 4-H YOUTH MEMORIAL AWARD APPLICATION

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This is an award for outstanding 4-H work during the past year.

Two awards will be presented: (1) in Grades K-7, (1) Grades 8-13

The award will be a cash voucher that can be used to pay for a 4-H activity at the club, county, state or national level. (Example: WI 4-H & Youth Conference, Leadership Washington Focus, Citizenship Washington Focus, Junior and Intermediate Camps, etc.)

COMPLETE THIS FORM BY SEPTEMBER 30

Nominee Name (Last, First, Middle I)

Name of 4-H Club

Number of Years in 4-H

Grade

Nominating Leader's Name

Rate this member as follows

Excellent

Good

Average

Attitude toward 4-H

Cooperation with leader

Work done for club

Quality of project work

Work on county level

Clear selection

Comments

Next Section To Be Filled out by Nominee (Member)

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