PORTFOLIO ENTRY FORM. This entry form is for the year: Street Address: Grade in School as of Jan. 1 st :
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1 PORTFOLIO ENTRY FORM One form per year. Update and replace annually. Member s Name: This entry form is for the year: # of yrs in 4-H (grades 3-12): Street Address: Grade in School as of Jan. 1 st : Date of Birth: City, State, Zip Home Phone Number: List 4-H projects / categories completed this year which are being reported in this record book: APPROVAL OF THIS REPORT We have reviewed this portfolio and believe it to be a correct reflection of this member s activities in the Utah 4-H Program: Date:, 20 Signed: Date:, 20 Signed: Date:, 20 Signed: Date:, 20 Signed: Date:, 20 Signed: Date:, 20 Signed: (Member) (Parent or Guardian) (Local 4-H Leader) (Local 4-H Leader) (Local 4-H Leader) (Extension Agent)
2 PROJECTS/ CATEGORIES CODE PROJECTS/CATEGORIES* CODE PROJECTS/CATEGORIES* CODE PROJECTS/CATEGORIES* A CITIZENSHIP & CIVIC EDUCATION D ENVIRONMENTAL EDUCATION & EARTH SCIENCE FI Reading Literacy AB Citizenship (local, state, national) DA Environmental Stewardship FJ Social Recreation Skills AC Cultural Education DB Earth, Water & Air FK Values Clarification ACA Genealogy DBA Geology & Minerals FL Character Education AD Global Education DBB Weather & Climate G PLANTS & ANIMALS AH Service Learning DBC Soils & Soil Conservation GA Ag in the Classroom AI Community Service DBD Water GB Animals B COMMUNICATIONS AND EXPRESSIVE ARTS DC Energy GBB Beef BA Communication Arts DD Forests, Rangeland & Wildlife GBC Birds & Poultry BAA Speaking/Radio/TV DDA Forestry GBD Cats BAB Writing/Poetry DDB Range Science GBE Dogs BB Performing Arts DDC Wildlife & Fisheries GBEG Raising Guide Dogs BBA Clowning/Mime DE Outdoor Education GBF Dairy Cattle BBB Dance Movement DEA Adventure/Challenge GBG Goats (dairy, hair meat) BBC Drama/Theater DEB Shooting Sports GBH Horse/Pony BBB Music/Sound DF Waste Management / Recycling GBI Rabbits/Cavies BC Visual Arts E HEALTHY LIFESTYLE EDUCATION BCA Arts and Crafts EA Chemical Health GBK Small Lap Animals, Pets BCAB Beading EB Mental & Emotional Health GBL Swine BCAC Ceramics EC Foods & Nutrition GBM Alpacas & Llamas BCAD Porcelain Doll ECB Foods Safety GC Plants BCAF Flower Arranging ECC Foods Preservation GCA Crops/Weeds BCAL Leather Craft ECD Foods Preparation GCB Flower Garden/House BCAP Paper Craft ECDB Breads GCC Gardens - Fruit/Vegetable BCAR Fabric Craft ECDO Outdoor Cooking H SCIENCE & TECHNOLOGY BCAV Plastic Canvas ECF Cake Decorating HA Science/Technology Literacy BCAW Wood Carving/Engraving ED Physical Health HB Biological Sciences BCB Drawing, Painting, Sculpture EDA Fitness & Sports HBA Animal Science BCC Graphics Arts, Displays, Exhibits EDBA Health Rocks HBC Entomology & Bees BCD Photography, Video EDC Home Nursing, First Aid, CPR HBH Poultry Science/Embryology C CONSUMER AND FAMILY SCIENCES EE Safety HBI Veterinary Science CA Child Development, Child Care EEA ATV Safety HC Technology & Engineering CB Clothing & Textiles EEE Emergency Preparedness HCA Aerospace CBA Sewing Construction F PERSONAL DEVELOPMENT & LEADERSHIP GBJ HCB Sheep Automotive CBB Wardrobe Management FA Career Exploration & Employability HCC Bicycle CBC Modeling FC Economics, Business & Marketing HCD Computer Technology CBD Quilting FCA Entrepreneurship HCDA Robotics CBE Knitting FCB Mini Society HCE Electric CBF Crochet FD Introductory 4-H Projects (5-8 yrs) HCF Electronics CBG Needlecraft/Knot Tying FE Hobbies & Collections HCFA GPS/GIS CC Consumer Education FF Leadership Skills Development HCFB HAM Radio CCA Financial Literacy FG Leisure Education (general) HCH Wood Science/Industrial CD Home Environment FH Personal Development (general) HD Physical Sciences *Categories are those with single letter codes.
3 SECTION 1 PART A PROJECT REPORT FORM PROJECT IDENTIFICATION Member s Name: Report Year: 4-H Project/Category: Yrs in this Project/Category: SIZE AND SCOPE DESIGN TABLE HERE OR SEE WEBSITE FOR TABLE EXAMPLES Choose the Example Project Report Form version from this website. Choose the project most applicable to view table examples.
4 SECTION 1 PART B PROJECT REPORT FORM KNOWLEDGE LEARNED: SKILLS LEARNED:
5 SECTION 2 4-H EXPERIENCES & ACTIVITIES Date Type of Experience or Activity Level
6 Date Type of Experience or Activity Level
7 SECTION 3 4-H ENTRIES, AWARDS & RECOGNITIONS Date Name of Contest Project or Item Entered Place and/or Award $ Value of Premiums if any Level
8 Date Name of Contest Project or Item Entered Place and/or Award $ Value of Premiums if any Level
9 SECTION 4 4-H LEADERSHIP Date Leadership Role Responsibilities Type Level
10 Date Leadership Role Responsibilities Type Level
11 SECTION 5 4-H COMMUNITY SERVICE Date Description of Community Service Level Hours
12 Date Description of Community Service Level Hours
13 SECTION 6 NON 4-H EXPERIENCES Date Description of Non-4H Experiences Organization
14 Date Description of Non-4H Experiences Organization
15 SECTION 7 MY 4-H STORY Year
16 SECTION 7 MY 4-H STORY Year
17
18 SECTION 8 4-H PHOTOGRAPHS Year
19
Division B-Communications & Expressive Arts
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