This is a club level award presented to any member who fills out the required number of actions. There’s a separate form for Primary members (4-H ages 5-8) and one for Junior, Intermediate, and Senior members (4-H age of 9 and up). The 4-H age is the age on December 31st of that 4-H year.
Finally, put the completed sheet (handwritten is perfectly fine) in the front of a completed record book (not bound in, but loose) so we can make a note at Club Judging and award to certificate. Don’t forget to put Super Member awards in the Honors section of your record book the next year!