Bsa The Silver Antelope Award Nomination Form
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5The
Silver
Antelope
Award
Nomination Form
The Silver Antelope Award, created in 1942, is the regional-level distinguished award of the Boy Scouts of America, acting through the National Court
of Honor. Recipients of this award are registered Scouters of exceptional character in their region to recognize their distinguished service to youth. To
prevent embarrassment, the candidate should not be notified of this nomination. Nomination forms with up to a limit of 2 recommendation letters
must be submitted together electronically with this form to the National Council at
no later than November 30 for
recognition the following year.
Name ________________________________________ Spouse’s name _____________________________________
Home address ____________________________________________________________________________________
City ________________________________________________ State _____________ Zip code ___________________
Country _______________________ Home phone ___________________ Mobile phone _______________________
Company name ______________________________________ Professional title ______________________________
Business address _________________________________________________________________________________
City _______________________________________________ State ________________ Zip code ________________
Business phone ___________________________ Email __________________________________________________
I confirm that the nominee lives by the principles of the Scout Oath and Scout Law in word and deed, and is exemplary in
his or her personal, family, and professional activities.
Confirmation by person submitting nomination___________________________________________________________
(Printed name)
Date _______________________
____________________________________________________________
(Signature)
Nominator’s contact phone _____________________________ Email ________________________________________
Name and location of nominee’s local council ____________________________________________________________
Scout executive approval _____________________________________________________________________________
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