"Clovers For Community"
Community Service Award Cover Sheet

Please submit this cover sheet with your "Clovers For Community" essay.
See preceding page for directions

		Individual Entry			Club/group entry

Name ____________________________________________________  Age _______
	(of individual entrant or contact person for group)

Address_______________________________________________________________

Phone # _______________________  E-mail (if applicable) _____________________

Project Name _______________________________  Unit ______________________

Date(s) of Project _______________________________________________________

Brief Description of project: _______________________________________________

____________________________________________________________________________________

____________________________________________________________________________________


Project participants (for group entry only):  (At least one participant must be a Senior
4-H'er, you may attach an additional page if necessary).

Name _________________________________________	Age__________________

Name _________________________________________	Age__________________

Name _________________________________________	Age  _________________

Name _________________________________________	Age _________________

(Check-off)

I/We are aware that we should prepare a poster session for the Share Fair at State 
4-H Congress. At least one person from our group will attend congress to present 
the poster session and accept any award that we receive.  

Who? ____________________________________

Signature of entrant or contact person ______________________________________________________

Signature of 4-H leader or project advisor ___________________________________________________

Signature of 4-H Agent _________________________________________________________________