Lifetime Achievement Award Form

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Mountaineer Area Council* Boy Scouts of America PAGE 1 of 9 The Mountaineer Area Council Lifetime Achievement Award is presented to outstanding adult Scouters who have demonstrated a desire and commitment to serve the Mountaineer Area Council. A person s record of accomplishments and dedication weigh heavily on being presented this award. This award is intended to recognize only those extraordinary Scouters who have influenced significantly and contributed to the vision, directions, and growth of the Mountaineer Area Council, Boy Scouts of America. Eligibility: 1. Scouter must currently be registered with the Mountaineer Area Council, Boy Scouts of America. 2. Scouter must have demonstrated and reinforced the Scout Oath and Scout Law during his/her lifetime. 3. Scouter must have served on committees on one of the following levels: unit, district, council, regional or national. 4. Scouter must be considered to have made contributions to the Mountaineer Area Council of an order greatly exceeding the normal accomplishments of an active volunteer. 5. Two registered members must write and submit recommendation letters showing what this Scouter has accomplished during his/her lifetime for the Mountaineer Area Council. 6. Scouter cannot submit his/her own nomination. 7. Completed application must be submitted with this form along with the recommendation letters and color photo (passport size headshot). To be considered for the current year, application must be postmarked by May 15 and mailed to Mountaineer Area Council, 1831 Speedway Ave, Fairmont, WV 26554. Executive Committee will have the final approval of applicants submitted from the Lifetime Achievement Award Committee. I am nominating the following Scouter for the Mountaineer Area Council Lifetime Achievement Award. The application form, recommendation letters and photo are attached. Nominated Scouter Name (Print) BSA# Your Name (Print) Your Signature Your address Your phone number Attached: nomination page (this page) photo (passport size headshot) nomination application two letters of recommendation

Mountaineer Area Council* Boy Scouts of America PAGE 2 of 9 THE AWARD The Lifetime Achievement Award is presented by the Mountaineer Area Council, Boy Scouts of America, through the local Council to adult volunteer Scouters for their distinguished service to youth and their community. The Award is intended to acknowledge noteworthy service of exceptional character to youth by registered Cub Scouters, Scouters, Varsity Scouters, and Venturing leaders within the territory under the jurisdiction of the local Council. ELIGIBILITY Any registered adult Scouter who has a record of quality service to Scouting, his or her community, is eligible for nomination. Nominations will not be considered for former professional Scouters or Council employees within 5 years of their leaving employment with the BSA (i.e., any form of fulltime or part-time employment such as secretary, ranger, or professional-technical position). Only under rare circumstances will awards be considered posthumously. NOMINATIONS Nominations may be initiated by adults who have served with the nominee or who are otherwise personally familiar with the nominee s service record. Nominations are due in the Council Office by May 15 to be considered for that year.

Mountaineer Area Council* Boy Scouts of America PAGE 3 of 9 PROCEDURES 1. Gather records and information for the Nominee in the service category. 2. Complete the Nomination Form, summarizing the Nominee s service record. 3. Two Letters of Recommendation: The Lifetime Achievement Award Selection Committee will not see the names of individuals and organization who submit letters of recommendation, or any other information that would lead to the identity of the Nominee. These letters allow the Committee to better understand the character of the Nominee. No more than four letters of recommendation will be accepted. 4. Include 2 photos of the nominee (preferably headshot, passport style.) 5. When the Lifetime Achievement Nomination packet is complete, please mail it to: Mountaineer Area Council, Boy Scouts of America Lifetime Achievement Award Selection Committee 1831 Speedway Ave. Fairmont,West Virginia 26554 Nominations are reviewed by an all-volunteer Award Selection Committee. Awards are presented at the Annual Council Recognition Dinner. The number of Lifetime Achievement Awards presented by Mountaineer Area Council is limited by Mountaineer Area policy. When the selection process is complete, the individual who submitted the nomination will be notified if the nominee was selected. Please work to ensure that the nominee is kept unaware of his or her nomination. If the nominee is not selected, the complete packet will be returned to the nominator. It is not uncommon for a nominee to be nominated several times without being selected. Nominators are encouraged to update the packet and re-submit it each year if their candidate is not selected.

Mountaineer Area Council* Boy Scouts of America PAGE 4 of 9 PERSONAL DATA In the event the award is granted, the Lifetime Achievement Certificate will be lettered exactly as seen below. Name Address Email Address Occupation The Nominee is registered in Scouting as Nominee s BSA membership certificate expiration date / /. If Nominee currently serves in a Unit: circle type, fill in Unit # and Chartered Organization. Pack / Troop / Team / Crew / Ship Unit # Chartered by Nomination Submitted By: Address: Phone: (H) (W) Email:

Mountaineer Area Council* Boy Scouts of America PAGE 5 of 9 RECORD UPON WHICH THIS NOMINATION IS BASED 1. Please list Registered Adult Positions in the Boy Scouts of America, with dates listed chronologically (indicate Unit No., Chartered Organization, and District where appropriate.) UNIT TYPES: Cub Scout Pack, Boy Scout Troop, Venturing Crew, Varsity Team, Sea Scout Ship, District, Council POSITIONS HELD, Include Years held, Unit Type and number, Chartering Organization, and District CR Chartered Org. Rep CC Committee Chair MC Committee Member CM Cubmaster CA Assistant Cubmaster TC Tiger Cub Coach DL Den Leader DA Assistant Den Leader WL Webelos Den Leader WA Asst Webelos Den Leader DC Den Leader Coach SM Scoutmaster SA Assistant Scoutmaster NL Crew Advisor NA Assistant Crew Advisor VC Varsity Coach VA Assistant Varsity Coach SK Skipper MT Mate Total number of years as a Registered Adult Volunteer: (so far!)

Mountaineer Area Council* Boy Scouts of America PAGE 6 of 9 DISTRICT POSITIONS District Chair District Vice-Chair District Committee Member Member at Large District Commissioner Assistant District Commissioner Unit Commissioner CS Roundtable Commissioner CS Roundtable Staff BS Roundtable Commissioner BS Roundtable Staff Merit Badge Counselor COUNCIL POSITIONS Council Board Chair Council Commissioner Assistant Council Commissioner Council Board of Directors Member Member at Large Council Committee Chair Council Committee Member Honorary Life Member AREA/REGION/NATIONAL POSITIONS

Mountaineer Area Council* Boy Scouts of America PAGE 7 of 9 2. List Activities or Training Events at the District and/or Council level when Nominee held a Chair or Staff position. DISTRICT Position Held Event Date COUNCIL Position Held Event Date 3. Awards or Recognition received as an Adult Volunteer in Cub Scouting, Boy Scouting, or Venturing. Please add a date to any awards received. Cub Scouts Tiger Cub Den Leader Award Cubmaster Award Cub Scouter Award Den Leader Award Webelos Den Leader Award Pack Trainer

Mountaineer Area Council* Boy Scouts of America PAGE 8 of 9 Boy Scouts Scouter s Training Award Scoutmaster s Key Scoutmaster Award of Merit Varsity Scout Leader Training Award Varsity Scout Coach s Key Troop Trainer Venturing Venturing Leader Training Award Crew Advisor Award of Merit Venturing Leadership Award Envision Award Venturing Leader Key District Committee District Committee Key Commissioner Service Arrowhead Honor Scouter s Key Unit Commissioner Scouter s Key ADC Scouter s Key District Commissioner Scouter s Key CS RT Commissioner Scouter s Key BS RT Commissioner Distinguished Commissioner Service Award Council Operating Committee Award of Excellence. Committee(s) Year(s) Other District Award of Merit Adult Religious Emblem (please indicate which denomination) James E. West Fellowship Order of the Arrow Ordeal Order of the Arrow Brotherhood Order of the Arrow Vigil Wood Badge 2 beads Wood Badge 3 beads Wood Badge 4 beads

Mountaineer Area Council* Boy Scouts of America PAGE 9 of 9 4. List any DISTRICT specific recognition or awards not listed above: 5. List any COUNCIL specific recognition or awards not listed above: 6. Training Record: