4-H HOME ENVIRONMENT RECORD 
(Record for floor plan and color scheme also available.)

Year  	

Name  	Age  	                           Years in 4-H  	                             

Room or area chosen for improvement _______________________________________________________

Project meetings held _________________________	Number of meetings attended ________________
 	
Beginning date ______________________________	Date when finished _________________________

List, on a separate line, each thing you plan to learn, make or do.	My family will do together	I will do myself	I/we did great	I did  Ok	Not so good	Plan to do
next year	

							

							

What did you like most about this activity or project?

                                                                                  

                                                                                    

                                                                                     

Learning Activities in this Project				
Indicate the number of times participated
L=club and local; C=county; D=district; S=state

  				  L      C     D     S  
Judging                                                                      
Field trip/tour                                                             
Project talks                                                               
Demonstrations                                                          
Total number of exhibits                                            

Attach a short story to include:
(1)	How you and your family worked together,
(2)	What you did and what other family members did,
(3)	At least one example of how you make choices in
selecting a carpet, bedspread, paint, where to
hang pictures, etc.,
(4)	How did you share your knowledge with others?

Other items made or purchased for your home and other things you did that are not listed on the front page.

Community service activities you and/or your family or club did related to this project.

Project Costs
Date	Things bought, supplies purchased and other costs 	Amount
                       	                                                                                                                 	$                           

                       	                                                                                                                 	                             

                       	                                                                                                                 	                             

							Total year’s project expenses	$                            

4-H Home Environment STORY & PHOTOS
Attach a separate sheet of paper with a story telling why you chose this project, talk about experiences, challenges, successes, activities, etc... May also include up to three (3) pages of photos.

 	
4-H Member signature	Project Leader signature

Kansas State University Agricultural Experiment Station and Cooperative Extension Service 
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