SEQUOIA COUNCIL SILVER BEAVER NOMINATION FORM
(Revised April 2011)
Due by December 31 District:
Send to:
Silver Beaver Awards Committee Date:
Sequoia Council
OR
You may submit your applications to any of the council service centers.
We take pleasure in submitting this nomination for the award of the Silver Beaver for distinguished service to youth. We nominate:
NAME:
ADDRESS:
CITY, STATE, ZIP:
If Scouter is now unit connected, give unit number and district. UNIT:
DISTRICT:
Evidence of nominee community standing and service to youth appears on pages 2 and 3
Respectfully submitted by: Name:
Please Print
Signature
Address:
City, State, Zip:
Phone: Home: Cell:
E-mail:
NAME: DISTRICT:
POSITION: DATE:
RECORD UPON WHICH THIS SILVER BEAVER NOMINATION IS BASED
A. Record of service in the Boy Scouts of America. (Name charter partner in cases where service is unit
connected.)
1. SCOUTING RECORD
A. As a youth
Dates: (from-to)
Cub: Highest Rank Achieved:
Scout: Highest Rank Achieved:
Venturer: Highest Rank Achieved:
Explorer: Highest Rank Achieved:
B. As an adult – Unit level activities or positions
Dates: (approximate)
1.
2.
3.
4.
5.
6.
C. District or council level activities and/or positions:
Dates (approximate)
1.
2.
3.
4.
5.
6.
D. Additional Scouting recognitions and awards:
Dates (Month and year)
Den Leader Training Award Wood Badge
D.L. Coach Training Award F.O.S. Participant
Cub Training Award Order of the Arrow Member
Scouter’s Training Award Order of the Arrow Adviser
Scouter’s Key NESA Award
District Award of Merit Dist. Commissioner Award
George Meany Award Lifesaving Award
Whitney Young Award Religious Award
E. Additional Comments:
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Letters of Recommendation may accompany this nomination. Letters could be from the nominee’s business contacts; Religious/Faith community and Scouting contacts.
2. I believe this candidate should be considered for the Silver Beaver Award because:
B. Statement covering the nominee’s standing in the community, citing activities in which nominee is
MOST ACTIVE in business, professional, civic, religious, educational, fraternal, veterans, rural
and other fields, exclusive of Scouting.
1. Occupation:
Employed by:
Title or Position:
2. Member of or officer of the following community activities or associations:
_________________________________________________________
3. Religious/Faith activities of nominee (please give dates and specifics of the
activities.)
Dates (Month/Year):
1.
2.
3.
4.
5.
C. Additional information not listed elsewhere to be reviewed in consideration this nominee for
the Silver Beaver Award:
Marital status: Number of children: Birth date: Age:
Educational background:
GENERAL INSTRUCTIONS
Annually, volunteers nominate men and women who are doing an outstanding job as Scouters for the Silver Beaver Award. These nominations are reviewed by the Council’s Silver Beaver Committee in January each year, and the most outstanding men and women are selected to receive this special recognition.
The committee welcomes all nominations and encourages you to recommend those nominees you believe worthy of this high honor. All names not selected in any given year will be reviewed for consideration the following year. The deadline for nominations is December 31st.
In filling out the nomination form, please keep in mind these helpful guidelines and suggestions:
1. Be sure to give the full name and titles (if any) of the nominee. Please do not use abbreviations,
initials only, or nicknames. (For example Robert H. Bradley; Doctor William Kelly; Captain
Arthur Smith; Reverend Donald Jones; the Honorable Jason Edwards; etc.)
2. Furnish as much information as possible for the sections on pages 2 and 3. For example, in
Section B: President Libertyville Rotary Club; Vestryman, St. Paul’s Church; chair, Red Cross
Campaign; Adjutant, American Legion Post 50; etc.
3. Long established policy limits the award of the Silver Beaver to those age 21 and older.
4. Nominations cannot be made for posthumous awards.
5. Please use only this Council nomination form.
6. Submit your completed nomination forms by NOT LATER THAN DECEMBER 31st
Send them to either:
Fresno Service Center Visalia Service Center
Sequoia Council, BSA or Sequoia Council, BSA
6005 N Tamera Ave 230 N Third Street
Fresno, CA 93711 Visalia, CA 93231
FAX (559) 320-2114 FAX (559)-732-0822
1. Revised (April 2011)