Eagle Scout Alumni Association Merit Scholarship 2020 Application
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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) (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 • Have demonstrated strong leadership and a spirit of service (NOTE: One’s college choice is not subject to this geograph- to others in or outside of Scouting. ic limitation). • A one-page statement is required of all applicants. This state- • Be a graduating high school senior or an undergraduate col- ment is limited to the space provided and must be in 12-point lege student not beyond one’s junior year (NOTE: Awardees Times New Roman font. If these stipulations are deviated may receive this scholarship once, only). from, the application will not be considered further, regard- less of content. Procedures: Important Notes: • The Eagle Scout who is registered in Patriots’ Path Council and is • All applications become the property of the ESAA Scholarship applying for this scholarship must complete the application per- Committee and will not be returned. sonally. • By December 15, the ESAA Scholarship Committee will notify • Include only what is requested; do not provide materials (e.g., those selected of its decision via letter or phone. This list of se- biographies, resumes, or supplemented lists of activities) not re- lectees will be posted on the council website (ppcbsa.org). No quested. written notification will be sent to applicants, except those select- ed. • Answer all questions on this application. Use only the space pro- vided. • Submitting an application is not a guarantee of a scholarship. ESAA Scholarship Committee decisions are final; there is no • Applications MUST BE TYPED into this form. Any application appeal process. 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 1 Scouting Record: POSITIONS HELD ADVANCEMENTS & AWARDS OTHER OPPORTUNITIES (Check all applicable) (Check all applicable) (Check all applicable) Senior Patrol Leader Total Merit Badges Earned: ______________ BSA Summer Camp Staff Assistant Senior Patrol Leader Eagle—Silver Palm National Scout Jamboree Patrol Leader Eagle—Gold Palm World Scout Jamboree Den Chief Eagle—Bronze Palm National Camping School Troop Guide Venturing—Ranger Award NAYLE—Participant Instructor Venturing—Silver Award NAYLE—Staff Junior Assistant Scoutmaster Venturing—Gold Award NYLT Leadership Academy—Participant Troop OA Representative Venturing—Bronze Award NYLT Leadership Academy—Staff Historian/Librarian/Scribe/Webmaster Venturing—Quest Award Council NYLT—Participant Chaplain Aide Venturing—Trust Award Council NYLT—Staff Troop Leave No Trace Trainer Sea Scout—Quartermaster Other: ______________________________ Troop Outdoor Ethics Guide Sea Scout—Able _____________________________________ Order of the Arrow—Brotherhood Member Sea Scout—Ordinary _____________________________________ Order of the Arrow—Elangomat Sea Scout—Apprentice RELIGIOUS Order of the Arrow—Lodge Chief Den Chief Service Award (Enter the number of years involved) Order of the Arrow—National Officer Honor Medal with Crossed Palms ___ Order of the Arrow—Ordeal Member Honor Medal Acolyte/Altar Server ___ Choir Order of the Arrow—Section Chief Heroism Award Church/Hebrew School/Other Aide Order of the Arrow—Vigil Honor Medal of Merit ___ ___ Youth Group Member Venturing Crew—President National Certificate of Merit ___ Youth Group Officer Venturing Crew—Vice President Hornaday Award: ____________________ ___ Other: ____________________________ Sea Scout Ship—Boatswain Religious Emblem: ___________________ Sea Scout Ship—Boatswain’s Mate Emergency Preparedness Award Sea Scout Ship—Purser 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 ___ National Honor Society ___ Choir/Chorale ___ Cheerleading ___ Boys/Girls State ___ Computer ___ Color Guard ___ Other:_________________________ ___ Debating/Forensics ___ Cross-Country/Track ___ Other: ________________________ ___ Drama/Theater ___ Dance Team COMMUNITY ___ Foreign Language: __________________ ___ Fencing ___ Future Business Leaders of America ___ 4-H Club ___ Field Hockey ___ Future Farmers of America ___ Blood/Platelet Donor ___ Football ___ History ___ Community Theater Volunteer/Actor ___ Golf ___ Interact Club/KeyClub ___ Exchange Student Host ___ Gymnastics ___ International ___ Firefighter Member/Cadet ___ Ice Hockey ___ Marching Band ___ Food Drive Solicitor/Donor ___ Lacrosse ___ Math ___ Girl Scout Gold Award ___ Shooting ___ Model United Nations ___ Hospital/Medical Center Volunteer ___ Soccer ___ Orchestra/Band ___ ___ Junior Achievement Softball ___ Robotics ___ ___ Red Cross Volunteer Swimming/Diving ___ Science ___ ___ Rescue Squad/EMS Member/Jr. Member Tennis ___ Student Council/Government ___ ___ Salvation Army Volunteer Volleyball ___ Students Against Drunk Driving (SADD) ___ ___ Town Pageant Winner: _______________ Wrestling ___ Yearbook/Magazine/Newspaper Staff ___ ____________________________ ___ Other: ____________________________ Other: ___ Other: ____________________________ ___ ___ Other: ____________________________ Team captain/co-captain ___ Other:____________________________ 2 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. 4 .