Bsa North Star Award Nomination Form Page 2

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b. Statement covering the nominee’s standing in the community, citing activities in which the individual is
most active in business, professional, civic, religious, educational, fraternal, veteran, rural, and other
fields exclusive of Scouting. (See instructions on reverse side.)
c. Record of noteworthy service of exceptional character to youth within the territory under the
jurisdiction of this council.
Nominated by ______________________________________ Council Headquarter City ____________________
Phone ________________ E-mail _____________________ Region ________________ Council No. __________
___________________________________ __________
_____________________________ __________
(Council Awards committee chair)
Date
(Scout Executive)
Date
Forms without appropriate signatures will not be considered.

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