Eagle Scout Alumni Association Merit Scholarship 2020 Application

EAGLE SCOUT ALUMNI ASSOCIATION
MERIT SCHOLARSHIP 2020 APPLICATION

Applicant’s Full Name ___________________________________________________________________________________________________
Last, First and Middle

Home Address _________________________________________________________________________________________________________

City _______________________________________________________________________ State _______________ ZIP Code ______________

Home Telephone __________________________ High School Graduation Date _____________________ Birth Date ______________________

(MM/DD/YYYY)

Eagle Scout Board of Review Date __________________ District ____________________ Troop Crew Ship Unit No. ______________
(MM/DD/YYYY)

Name(s) of parent(s) or guardians(s) ________________________________________________________________________________________

Address (if different from yours) ___________________________________________________________________________________________ City _______________________________________________________________________ State _______________ ZIP Code ______________ Current School ___________________________________________________________________ City __________________________________ Intended educational institution beyond current _______________________________________________________________________________

Requirements:

•

Be an Eagle Scout registered in Patriots’ Path Council BSA (NOTE: One’s college choice is not subject to this geographic limitation).

••

Have demonstrated strong leadership and a spirit of service to others in or outside of Scouting.

A one-page statement is required of all applicants. This statement is limited to the space provided and must be in 12-point Times New Roman font. If these stipulations are deviated from, the application will not be considered further, regardless of content.

•

Be a graduating high school senior or an undergraduate college student not beyond one’s junior year (NOTE: Awardees may receive this scholarship once, only).

Procedures:
Important Notes:

•

The Eagle Scout who is registered in Patriots’ Path Council and is

applying for this scholarship must complete the application per-

sonally.

•

All applications become the property of the ESAA Scholarship

Committee and will not be returned.

•

By December 15, the ESAA Scholarship Committee will notify those selected of its decision via letter or phone. This list of selectees will be posted on the council website (ppcbsa.org). No written notification will be sent to applicants, except those selected.

•

Include only what is requested; do not provide materials (e.g.,

biographies, resumes, or supplemented lists of activities) not re-

quested.

••

Answer all questions on this application. Use only the space provided.

••

Submitting an application is not a guarantee of a scholarship. ESAA Scholarship Committee decisions are final; there is no appeal process.
Applications MUST BE TYPED into this form. Any application that is handwritten, except signatures on page 4, will not be ac-

cepted.

Applications must be mailed via U.S. Postal Service; faxes,

emails or email attachments will not be accepted.

•

Mail your completed application by November 1st to: PPC-ESAA Scholarship Committee

1 Saddle Road, Cedar Knolls, NJ 07927.

Rev. 01.20.2018

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Scouting Record:

POSITIONS HELD

ADVANCEMENTS & AWARDS

OTHER OPPORTUNITIES

(Check all applicable)

Total Merit Badges Earned: ______________ Eagle—Silver Palm Eagle—Gold Palm
Senior Patrol Leader Assistant Senior Patrol Leader Patrol Leader
BSA Summer Camp Staff National Scout Jamboree World Scout Jamboree

Eagle—Bronze Palm

Den Chief

Troop Guide Instructor Junior Assistant Scoutmaster Troop OA Representative Historian/Librarian/Scribe/Webmaster Chaplain Aide Troop Leave No Trace Trainer Troop Outdoor Ethics Guide

Order of the Arrow—Brotherhood Member

Order of the Arrow—Elangomat Order of the Arrow—Lodge Chief Order of the Arrow—National Officer Order of the Arrow—Ordeal Member Order of the Arrow—Section Chief Order of the Arrow—Vigil Honor Venturing Crew—President Venturing Crew—Vice President Sea Scout Ship—Boatswain Sea Scout Ship—Boatswain’s Mate Sea Scout Ship—Purser
National Camping School NAYLE—Participant NAYLE—Staff NYLT Leadership Academy—Participant NYLT Leadership Academy—Staff Council NYLT—Participant
Venturing—Ranger Award Venturing—Silver Award Venturing—Gold Award Venturing—Bronze Award Venturing—Quest Award Venturing—Trust Award Sea Scout—Quartermaster Sea Scout—Able

Sea Scout—Ordinary

Sea Scout—Apprentice Den Chief Service Award Honor Medal with Crossed Palms Honor Medal Heroism Award Medal of Merit National Certificate of Merit Hornaday Award: ____________________ Religious Emblem: ___________________ Emergency Preparedness Award
Council NYLT—Staff Other: ______________________________ _____________________________________

_____________________________________

RELIGIOUS

(Enter the number of years involved)

___ ___
Acolyte/Altar Server Choir Church/Hebrew School/Other Aide Youth Group Member Youth Group Officer
___ ___ ___

___

____________________________

Other:

Sea Scout Ship—Yeoman

Education & Community Record:

Enter the number of years you have been involved in the activity.

VARSITY TEAM MEMBER

SCHOOL CLUBS & GROUPS

___ Baseball

RECOGNITIONS & AWARDS

___Chess
___ Basketball

___ Cheerleading ___ Color Guard

___ Cross-Country/Track

___ Dance Team

___ Fencing
___Choir/Chorale

___ National Honor Society ___ Boys/Girls State

___ Other:_________________________

___ Other: ________________________

___Computer ___Debating/Forensics ___Drama/Theater ___Foreign Language: __________________ ___Future Business Leaders of America ___Future Farmers of America ___History

COMMUNITY

___ 4-H Club

___ Field Hockey

___ Football

___ Blood/Platelet Donor

___ Community Theater Volunteer/Actor ___ Exchange Student Host
___ Golf
___Interact Club/KeyClub

___International

___ Gymnastics

___ Ice Hockey ___ Lacrosse
___ Firefighter Member/Cadet ___ Food Drive Solicitor/Donor ___ Girl Scout Gold Award
___MarchingBand ___Math

___ Shooting

___Model United Nations ___Orchestra/Band
___ Hospital/Medical Center Volunteer ___ Junior Achievement
___ Soccer ___ ___ ___

Softball

___Robotics
___ Red Cross Volunteer
Swimming/Diving

Tennis
___Science
___ Rescue Squad/EMS Member/Jr. Member

___ Salvation Army Volunteer ___ Town Pageant Winner: _______________

___ Other: ____________________________

___ Other: ____________________________
___Student Council/Government ___Students Against DrunkDriving(SADD) ___Yearbook/Magazine/Newspaper Staff ___Other:____________________________

___ Other:____________________________

___ ___
Volleyball Wrestling

____________________________

___ ___

Other: Team captain/co-captain

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Personal Statement:

(Respond to the question below. Use no more than this one page. Use 12 - point Times New Roman font, single - space.)

As an Eagle Scout, how do you intend to live by the Scout Oath and Law and be a responsible, contributing citizen throughout the rest of your life?

3

Authorization:

We hereby authorize the ESAA Scholarship Committee to request and obtain any further information deemed necessary.

On my honor as a Scout, all information and statements on this form are true and correct.

______________________________________________________________________________________________________________

Signature of Applicant

Date

I have read this application and it has my approval.

_____________________________________________________________________________________________________________

Signature of Parent or Guardian Date

_____________________________________________________________________________________________________________

Signature of Parent of Guardian

Date

Mail this completed application to:
Eagle Scout Alumni Association-Scholarship Committee
Patriots’ Path Council—BSA
1 Saddle Road, Cedar Knolls, New Jersey 07927

Visit www.alumni.ppbsa.org
For the online version of this form.

Call 973.765.9322 ext. 232 with any questions or concerns.

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