My name is,



4-H Year 20______

Burnett County 4-H

Member Record

My name is ___________________________________________

I am _______ years old.

I am in ________ grade.

I go to the ________________________ School.

I am a member of the ________________________4-H Club.

This is my _________ year in 4-H.

Number of projects I took this year: ______

(Paste photo here)

Rev. 8/19/13

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( The information in this record book is true and of my own work.

Member Signature_____________________________________________

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