Schenectady District
Twin Rivers Council, Boy Scouts of America
District Award of Merit
Read through the application completely before filling out the application.
Verify the applicant meets the Requirements of Eligibility before continuing.
· Exceptional Service to both their unit and the District.
· Nominees must show Scout Spirit.
· A minimum of three years of current registration and/or active service with the Boy Scouts of America.
Print or type legibly all information sections.
Nominee’s name should only be mentioned on the first page. Use the term Scouter or nominee in the application after page one.
If more space is needed for the Why This Scouter section, attach additional information on a separate page.
Remember to be discrete in obtaining the personal information necessary to complete the application form. All nominations for the Award of Merit will be kept confidential.
No self-nominations will be accepted.
The person submitting the nomination will be contacted if their nominee is chosen. Nominator must arrange to have the applicant and their significant other at the District Recognition Dinner to receive the Award of Merit recognition.
Return form to:
Boy Scouts of America
Schenectady District Awards - Nomination Committee
PO Box 13143
Albany, NY 12212
Nomination form must be received by April 15th, 2014.
For questions please contact:
Pieter Lansing
e-mail:
Cell: 796-8628
Award of Merit Nomination Form
To the District Awards Committee: I take pleasure in presenting for consideration the
nomination of the Scouter named below for the District Award of Merit.
Person Being Nominated:
Name______
Address______City /State/Zip______
Phone email:______
Currently registered in Scouting as______
(List position in unit, district, or council)
Family Background:
Spouse’s Name______
Number of Children______
Boy’s ages______Girls’ ages ______
Were children in Scouting? ______
Business / Profession / Occupation and title
______
Person making nomination:
Name______
Address______City / State / Zip______
Phone email: ______
Position in Scouting______
Scouting Tenure:
List the Nominee’s registered positions and the years of service in a pack, troop, crew or district.
______
Scouting Positions From To Total Years
Service To Scouting:
List the Nominee’s areas of service to Scouting, such as a member of a district committee or as staff for
events.
______
Scouting Service From To Total Years
Scouting Awards and Honors (check and list date):
Training Awards Year Recognitions Year
Tiger Cub Den Leader Award ______
Order of the Arrow: Ordeal ______Brotherhood ______Vigil ______
Den Leader Award ______
Webelos Den Leader ______
Cubmaster Award ______
Wood Badge (beaded) ______
Cub Scouter Award ______
Wood Badge (not beaded) ______
Scouter’s Training Award ______
Religious Award (Adult) ______
Scouter’s Key ______
Philmont Training Course ______
Venturing Training Award ______
Scoutmaster Award of Merit ______
Arrowhead Honor (Commissioner) ______
Outstanding Unit Scouter Award ______
Commissioner Key ______
Others, please list ______
Service to God, Country, State, Community and Youth
Because the Scouting program emphasizes service to others briefly describe this Scouter’s community involvement.
______
Why This Scouter:
In your own words, tell the nominations committee why this Scouter should receive the District Award of Merit. How has Scouting benefited from this Scouter’s involvement?
______
Please list any information you feel could help:
______