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 UTAH 4-H 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 EDUC ATION & EARTH SCIENCE FI Reading Literacy AB Citizenship (local, state, national) DA Env ironmental Stewardship FJ Social Recreation Skills AC Cultural Education DB Earth, Water & Air FK Values Clarif ication ACA Genealogy DBA Geology & Minerals FL Character Education AD Global Education DBB Weather & Climate G PL ANTS & ANIMALS AH Serv ice Learning DBC Soils & Soil Conserv ation GA Ag in the Classroom AI Community Serv ice DBD Water GB Animals B COMMUNICATIONS AND EXPRESSIVE AR TS DC Energy GBB Beef BA Communication Arts DD Forests, Rangeland & Wildlif e GBC Birds & Poultry BAA Speaking/Radio/TV DDA Forestry GBD Cats BAB Writing/Poetry DDB Range Science GBE Dogs BB Perf orming Arts DDC Wildlif e & Fisheries GBEG Raising Guide Dogs BBA Clowning/Mime DE Outdoor Education GBF Dairy Cattle BBB Dance Mov ement DEA Adv enture/challenge GBG Goats (dairy, hair meat) BBC Drama/Theater DEB Shooting Sports GBH Horse/Pony BBB Music/Sound DF Waste Management / Recycling GBI Rabbits/Cav ies BC Visual Arts E HEALTH Y LIFESTYLE EDUCATION GBJ Sheep BCA Arts and Craf ts 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 Saf ety GC Plants BCAF Flower Arranging ECC Foods Preserv ation GCA Crops/Weeds BCAL Leather Craf t 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 Canv as ECF Cake Decorating HA Science/Technology Literacy BCAW Wood Carv ing/engrav ing ED Phy sical Health HB Biological Sciences BCB Drawing, Painting, Sculpture EDA Fitness & Sports HBA Animal Science BCC Graphics Arts, Display s, Exhibits EDBA Health Rocks HBC Entomology & Bees BCD Photography, Video EDC Home Nursing, First Aid, CPR HBH Poultry Science/Embry ology C CONSUMER AND FAMIL Y SCIENCES EE Saf ety HBI Veterinary Science CA Child Dev elopment, Child Care EEA ATV Saf ety HC Technology & Engineering CB Clothing & Textiles EEE Emergency Preparedness HCA Aerospace CBA Sewing Construction F PERSON AL DEVELOPMEN T & LEADERSHIP HCB Automotiv e CBB Wardrobe Management FA Career Exploration & Employ ability HCC Bicy cle 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 y rs) HCF Electronics CBG Needlecraft/Knot Ty ing FE Hobbies & Collections HCFA GPS/GIS CC Consumer Education FF Leadership Skills Dev elopment HCFB HAM Radio CCA Financial Literacy FG Leisure Education (general) HCH Wood Science/Industrial CD Home Env ironment FH Personal Dev elopment (general) HD Phy sical Sciences *Categories are those with single letter codes.

3 UTAH 4-H SECTION 1 PART A PROJECT REPORT FORM PROJECT IDENTIFICATION Member s Name: Report Year: 4-H Project/Category: _Livestock Yrs in this Project/Category: SIZE AND SCOPE Hours Spent Income Description Hours Amount Attending 4-H Club Meetings/Activities Feeding Grooming Training to Lead Other Sale Price Ribbon Premium Money Boosts Other Income Total Income Total Hours Spent Production Summary Expenses Description Description Total Cost A. Beginning Weight Animal Purchase Expenses B. Beginning Date Feed Expenses 1 C. Ending Weight Feed Expenses 2 D. Ending Date Feed Expenses 3 E. Total Weight Gained = C A Equipment Expenses F. Number of days on feed = D - B Health Expenses Average Daily Gain = E / F Other Expenses G. Total pounds of feed Total Expenses Pounds gained per pound of feed = E/G Profit/Loss = Total Income Total Expenses

4 UTAH 4-H SECTION 1 PART B PROJECT REPORT FORM KNOWLEDGE LEARNED: SKILLS LEARNED:

5 Level UTAH 4-H SECTION 2 4-H EXPERIENCES & ACTIVITIES Date Type of Experience or Activity

6 Level Date Type of Experience or Activity

7 Level UTAH 4-H SECTION 3 4-H ENTRIES, AWARDS & RECOGNITIONS Date Name of Contest Project or Item Entered Place and/or Award $ Value of Premiums if any

8 Level Date Name of Contest Project or Item Entered Place and/or Award $ Value of Premiums if any

9 Type Level UTAH 4-H SECTION 4 4-H LEADERSHIP Date Leadership Role Responsibilities

10 Type Level Date Leadership Role Responsibilities

11 Level Hours UTAH 4-H SECTION 5 4-H COMMUNITY SERVICE Date Description of Community Service

12 Level Hours Date Description of Community Service

13 Organization UTAH 4-H SECTION 6 NON 4-H EXPERIENCES Date Description of Non-4H Experiences Revised 07/2008

14 Organization Date Description of Non-4H Experiences Revised 07/2008

15 UTAH 4-H SECTION 7 MY 4-H STORY Year

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17 UTAH 4-H SECTION 8 4-H PHOTOGRAPHS Year

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