4-H LEADERSHIP TEAM APPLICATION Community Club Leader ...

4-H LEADERSHIP TEAM APPLICATIONCommunity Club Leader CommentsApplicant’s NameApplicant’s Club____________________________________________________________________________________________________________________Community Club Leader’s Name______________________________________________(if CCL is related to applicant, this may be completed by Co-CCL or a project leader)This Mariposa County 4-H member is applying for the Mariposa County 4-H Leadership Team. Theform must be completed and returned by the Community Club Leader to the 4-H Office. It can NOTbe returned with the completed application. You are under no obligation to provide a copy of thisletter to the applicant. Please complete this statement privately and honestly and return to theoffice by November 9, 2012.To what degree do you recommend the applicant?Highly (1) Good (2) Okay (3) Doubtful (4)Personal rating of the applicant (circle for each characteristic)High Fair LowLeadership 1 2 3 4 5 6 7 8 9 10Citizenship 1 2 3 4 5 6 7 8 9 10Attitude 1 2 3 4 5 6 7 8 9 10Personality 1 2 3 4 5 6 7 8 9 10Enthusiasm 1 2 3 4 5 6 7 8 9 10Cooperation 1 2 3 4 5 6 7 8 9 10Dependability 1 2 3 4 5 6 7 8 9 10Responsibility 1 2 3 4 5 6 7 8 9 10Motivation 1 2 3 4 5 6 7 8 9 10Judgment 1 2 3 4 5 6 7 8 9 10Public Speaking 1 2 3 4 5 6 7 8 9 10Comments (use other side if needed). Describe applicant’s initiative, ability to work with others, levelof self-confidence and potential. Feel free to add any other comments which may be helpful to theselection committee.Signed ________________________________________ Date ______________________Title ________________________________________ Phone number ______________MC revised 1/2012

MARIPOSA COUNTY 4-H LEADERSHIP TEAM APPLICATIONCURRENT YEAR SUMMARYNameTell a little about your 4-H experience during 2011-12 year-Tell about your projects and goals for 2012-13 year-Are you a Junior or Teen Leader? Yes No If so, what projects?_________________________________________________________________________________________________Also show your activities outside of 4-H in school and the community.MC revised 1/2012

MARIPOSA COUNTY 4-H LEADERSHIP TEAM APPLICATIONCompleted written application is due to the 4-H Office by 5:00 pm extended to November 9,2012. Applicants may be invited to an interview as part of the selection process. Interviews will betake place at the 4-H office; date & time to be announced.NameClubAddressPhone number Number of years in 4-H Current Star RankAge on December 31 of current school yearSchool attendingPresent grade in schoolI would like to be on the 4-H Leadership Team because: (minimum of 250 words)Statement of applicant:I meet the selection criteria as outlined in the Mariposa County Leadership Team Information sheet.I am aware of the responsibilities, time involvement and costs described. I understand that I amresponsible for completing the year with the Leadership Team or 4-H Council may ask me to repayall or a portion of my LCORT and/or State Leadership Conference registration fees.I am willing to be interviewed by the selection committee. I will be prepared to talk about myinvolvement in 4-H and my future plans.Date , 2012 __________________________________________Signature of applicantStatement of parent or guardian:I will support my son/daughter if he/she is selected as a member of the Mariposa County 4-HLeadership Team. I am aware that there may be non-reimbursed expenses for transportation for myson/daughter to complete the team responsibilities. I understand that my son/daughter is responsiblefor completing the year with the Leadership Team or 4-H Council may ask me to repay all or aportion of his/her LCORT and/or State Leadership Conference registration fees.Date ____________________, 2012_____________________________________________Signature of parent or guardianMC revised 1/2012

2012-13 MARIPOSA COUNTY 4-H LEADERSHIP TEAM APPLICATION1. The Leadership Team is a training program for 4-H teen members who wish to gain additionalexperience in leadership and public speaking. The teen members will work with an adult leaderadvisor.2. Selection Criteria: Minimum of 13 years of age during year of application Have completed at least the eighth grade by July 1 of year applying Completed at least 2 years of 4-H membership and project experience with written records Completed at least one year as a Junior or Teen Leader, with written report Achieved Bronze Star rank by the time of application3. Member will show in written application: Experience in leadership, public speaking and citizenship/community service Active interest in project, club and county-wide 4-H events and activities A strong interest in continuing in the 4-H program4. Written application to include: Application form Current Year Summary Letter of recommendation from Community Club Leader, mailed separately by leader Include 4-H record book for review5. A selection committee will be appointed by 4-H Council to review the applications. Applicantswill have an oral interview. Applicants should realize that meeting the minimum criteria does notguarantee selection.6. Responsibilities to be shared with team members- Attend Leadership Team orientation and planning meetings throughout the year. Attend LCORT and/or California 4-H State Leadership Conference, and at least one of thequarterly Sectional 4-H Council meetings and report back to 4-H Council. Assist the All Star Team, 4-H Thrive Management Team or event chairperson with county 4-Hevents such as Achievement Night, Presentation/Favorite Foods Day, Fashion Revue, 4-H Thrivetraining, Kid’s Night, Teen Night, and Ironstone Concours d’Elegance. Team members willdivide up events so the team is represented and actively participating in important events.Each team member must participate in a minimum of 5 events. Assist with and attend the county Junior/Teen Leader Training or 4-H Thrive. If possible, participate in a Public Speaking project during the year If needed, plan and present a session at LCORT (Leadership Conference of Regional Teens) withthe All Star Team. Sectional Council restricts the number of leadership team members (10 thgrade & up) to five attending, so all team members may not be part of the session presentationteam. Promote 4-H activities at the club and county level. Set an example and challenge the younger members to work toward the goals of 4-H & StarRanks. Complete a record book/PDR and 80% attendance for club and project(s) for the year Leadership Team term: October 1 through September 307. Costs: Mariposa County 4-H Club Council supplies each Leadership Team member with a teamshirt. Council covers the registration fees for team members to attend the State LeadershipConference once. Registration fees will be covered for team members presenting sessions at LCORT.MC revised 1/2012