District Award Of Merit Award

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DISTRICT AWARD OF MERIT AWARD
The District Award of Merit is presented to registered Scouters with exceptional
character within our District for distinguished service to youth.
NOTE: The nomination is confidential. To avoid possible disappointment, please do
not advise nominee in any way of your action on their behalf.
If award is granted, we plan to present it at the District Dinner on March 4, 2016.
The recipient should attend the ceremony.
The nomination must be contained on this form with an additional one-page supplement allowed.
NOMINEE:
Name:
Unit:
_
Address:
_City
ZIP
Occupation:
_
Day Phone (
)
Evening Phone (
)
Registered in Scouting as:
and holds a certificate expiring on Dec. 31, 2015.
Number of years registered in Scouting as an adult
as a youth
RECORD UPON WHICH THIS NOMINATION IS BASED
(Give pertinent facts, dates, offices held. If more space is needed, one additional page will be accepted.)
a. Record of service in the Boy scouts of America. (Name organizations in cases where service is not unit
connected.)
b. Statement covering the nominee’s standing in the community, citing activities in which the individual is the
most active in business, professional, civic, religious, educational, fraternal, veterans, rural, and other fields
exclusive of Scouting.
c. Record of noteworthy service, of exceptional character to youth within the territory under the jurisdiction of this
council.
Application submitted by
Phone number
This completed form and a maximum one-page narrative must be submitted by 9:00p, Sunday, January 31, 2016.
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