Emmett J. Doerr Memorial Scout Scholarship Application

/ EMMETT J. DOERR
MEMORIAL SCOUT SCHOLARSHIP
2018 APPLICATION /

National Catholic Committee on Scouting® • Boy Scouts of America •

1325 West Walnut Hill Lane, P. O. Box 152079, Irving, TX 75015 2079

Page 2 www.nccs-bsa.org

Emmett J. Doerr Memorial Scout Scholarship Application

Name: Date:

Date of Birth: Phone:

Mailing Address

Street / P.O. Box:

City, State, Zip Code:

E-mail Address:

Unit: Troop # Team # Crew # Ship #

Unit Chartered To:

Date of Eagle Scout, Venturing Silver or Sea Scout Quartermaster Award

Date of Ad Altare Dei and/or Pope Pius XII

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T
A
P
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(NOTE: Additional sheets of paper may be used if needed to answer each of the following sections to the fullest.)

1)  Document reasons why you should be selected as a recipient of the Emmett J. Doerr Scholarship

2) List dates and positions held in Scouting:

Give a short description of your Eagle Scout or Quartermaster Service Project (if applicable)

List Scouting awards received:

3)  Service to the Church—What have you done or are currently doing, positions held (if any), and for how long? Include any awards you may have received.

4) GPA_____/Scale_____ Name of Honor Society(ies)

Service to the School—What have you done or are currently doing, positions held (if any), and for how long?

List school awards received:

5)  Service to the Community - What have you done or are currently doing, positions held (if any), and for how long?

List community awards received:

6)  List any other organizations, activities, positions held, length of service, awards received or any other information that you would like the Scholarship Committee to consider.

Press Release Waiver

In the event of your selection as a scholarship recipient, we will be issuing a press release to the national media. To do this, we need your permission. Your decision, in no way, affects our selection process.

I, , give permission to the National Catholic Committee on Scouting® to release my name and photograph for the purpose of recognizing my award of an Emmett J. Doerr Memorial Scout Scholarship.

By this authorization, I understand and agree that no recipient shall receive remuneration and that all rights, title and interest to the photos and/or text and their use belongs to the National Catholic Committee on Scouting®.

I also understand that members of the press may request interviews with recipients, and that the recipients have the right to decline such interviews. This agreement is in effect until October 1 of the scholarship award year.

Signature of Applicant

Signature of Parent or Legal Guardian (if applicant is under 18 years old)

Name and Address of Your Local Catholic Newspaper (if available): ______
______
______

Checklist

¨  1. Complete application

¨  2. Include four (4) signed letters of recommendation:

·  One letter from your religious institution

·  One from your Scout unit

·  One from your school

·  One from your community

¨ 3. Include an official high school transcript.

¨ 4. Staple a 3”x5” photograph of yourself to the front of the application

¨ 5. Include an acceptance letter from an accredited institution of higher learning, if already accepted (optional)

¨ 6. Mail the completed application, along with the items above, to arrive no later than March 1st (recipients will be announced by May 15th) to:

Boy Scouts of America

Attn: NCCS—Emmett J. Doerr Memorial Scout Scholarship

P.O. Box 152079

Irving, TX 75015-2079

National Catholic Committee on Scouting® • Boy Scouts of America •

1325 West Walnut Hill Lane, P. O. Box 152079, Irving, TX 75015 2079

Page 2 www.nccs-bsa.org