Mecklenburg County 4-H

Monthly Report Form

4-H Club / Site Name:          Month:         Year: 

Email Address: 

4-H Curriculum Used: 

Name of Volunteer / Staff:   # of Hours Using 4-H: 

Name of Volunteer / Staff:   # of Hours Using 4-H: 

Name of Volunteer / Staff:   # of Hours Using 4-H: 

Name of Volunteer / Staff:   # of Hours Using 4-H: 

Total Number of Participants by Grade:
Kindergarten First Grade Second Grade Third Grade
Fourth Grade Fifth Grade Sixth Grade Seventh Grade
Eighth Grade Ninth Grade Tenth Grade Eleventh Grade
Twelfth Grade  

 

Total Number of Participants by Gender and Ethnic Group
  Caucasian African American American Indian Asian Native Hawaiian or Pacific Islander Mix Other
Non-Hispanic Male
Non-Hispanic Female
Hispanic Male
Hispanic Female

Additional Comments: