Silver Beaver Nomination Form

Silver Beaver Award Nomination Form

For questions, please email support@nhscouting.org
Date

MonthDayYear
Date
General Biography Information
Nominee Name*

PrefixFirst NameMiddle NameLast NameSuffix
Spouse/Partner Name

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Primary Phone Number*
Please enter a valid phone number.
Alternative Phone Number
Please enter a valid phone number.
Company Name
Occupation
Professional Title(s)
Primary Scouting Position*
District Name*
Scouting Affiliation Type*
Unit Number
If applicable
Total Number of Years Registered as an Adult Volunteer*
The nominee is currently registered in the council and holds a valid membership certificate.*

YesNo

Nominee's Record of Service in Scouting America

Please list the nominee's registered adult positions in Scouting America with dates listed chronologically. Indicate unit number, chartered organization, and district where appropriate.

Council-Level Leadership Roles

District-Level Leadership Roles

Unit-Level Leadership Roles

What significant council-level service to youth has been made by this nominee?*
Training Courses

Please indicate which training courses the nominee participated in and/or staffed with year completed.

Training Courses

	Participant	Staff/Faculty
Florida Sea Base Conference
Kodiak or Kodiak X Staff
National Youth Leadership Training (NYLT) Staff
National Advanced Youth Leadership Experience (NAYLE) Staff
National Camping School
National Junior Leader Instructor Camp (NJLIC)
Philmont Leadership Challenge
Philmont Training Center Conference
Powder Horn
Seabadge
Wood Badge

Other BSA Training Courses

I need to add more training courses

NoYes
Additional BSA Training Course History
Please list one course per line. Please indicate if you were a participant or on the course faculty/staff
Scouting Recognition

Scouting Honors

	Year Earned
Adult Religious Award
Arrow of Light
Arrowhead Honor
Distinguished Commissioner Service Award
Distinguished Eagle Scout
District Award of Merit
Eagle Scout
James E. West Society Fellowship Award
Order of the Arrow Member
Order of the Arrow Vigil Honor
National Eagle Scout Association
NESA Outstanding Eagle Scout Award
Scouter's Key
Scouter's Training Award
Silver Award
Unit Leader Award of Merit
Whitney M. Young Jr. Service Award
Youth Religious Emblem

Other Scouting Awards including Cub, Explorer, Learning for Life, STEM, Varsity and Venturing

I need to add more awards

NoYes
Additional Scouting America Award History
Please list one award with the year earned per line.
Noteworthy Service of Exceptional Character to Youth Outside of Scouting

Please list organization, position held, recognition received and year(s) involved or awarded.

Noteworthy Organization History

Please add any additional noteworthy comments on service of character to youth outside of Scouting:
Additional Noteworthy Comments of the Nominee's Standing in the Community

Information covering the nominee’s standing in the community, citing activities in which he/she is most active in business, professional, civic, religious, educational, fraternal, veterans, and other non-Scouting areas.

Noteworthy Community Service History

Additional Comments
If available, please attach any letters of recommendation

Cancelof
Confirmation
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/her personal, family, and professional activities.*

YesNo
Name of Person Submitting Nomination Form*

First NameLast Name
Position in Scouting*
Email*
example@example.com
Primary Phone Number*
Please enter a valid phone number.
Alternative Phone Number
Please enter a valid phone number.
Should be Empty:

General Biography Information