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)
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.
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 http://www.utah4-h.org/htm/general-forms/portfolios Choose the Example Project Report Form version from this website. Choose the project most applicable to view table examples.
SECTION 1 PART B PROJECT REPORT FORM KNOWLEDGE LEARNED: SKILLS LEARNED:
SECTION 2 4-H EXPERIENCES & ACTIVITIES Date Type of Experience or Activity Level
Date Type of Experience or Activity Level
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
Date Name of Contest Project or Item Entered Place and/or Award $ Value of Premiums if any Level
SECTION 4 4-H LEADERSHIP Date Leadership Role Responsibilities Type Level
Date Leadership Role Responsibilities Type Level
SECTION 5 4-H COMMUNITY SERVICE Date Description of Community Service Level Hours
Date Description of Community Service Level Hours
SECTION 6 NON 4-H EXPERIENCES Date Description of Non-4H Experiences Organization
Date Description of Non-4H Experiences Organization
SECTION 7 MY 4-H STORY Year
SECTION 7 MY 4-H STORY Year
SECTION 8 4-H PHOTOGRAPHS Year