The Nomination Form

The Silver Antelope Award, created in 1942, is the regional-level distinguished award of the , acting through the National Court of Honor. Recipients of this award are registered Scouters of exceptional character in their region to recognize their distinguished service to youth. To prevent embarrassment, the candidate should not be notified of this nomination.

GENERAL NOMINEE AND NOMINATOR INFORMATION

Name ______Spouse’s name ______

Home address ______

City ______State ______Zip code ______

Country ______Home phone ______Mobile phone ______

Company name ______Professional title ______

Business address ______

City ______State ______Zip code ______

Business phone ______Email ______

I confirm that the nominee lives by the principles of the Oath and in word and deed, and is exemplary in his or her personal, family, and professional activities.

Confirmation by person submitting nomination______(Printed name)

Date ______(Signature)

Nominator’s contact phone ______Email ______

Name and location of nominee’s local council ______

Scout executive approval ______MAJOR ELECTED AND APPOINTED POSITIONS

NATIONAL Position From To

______

REGIONAL ______

AREA ______COUNCIL ______

DISTRICT ______

UNIT ______

Youth Scouting tenure ______Adult Scouting tenure ______

SCOUTING RECOGNITION

Scouting Honors Type Year Type Year Type Year Eagle Scout National Eagle Scout Association Distinguished Eagle Scout Award God and Country God and Service Arrow of Light Award member Order of the Arrow Vigil Honor Whitney M. Young Jr. Service Award Silver Award James E. West Society Fellowship Award District Award of Merit Scoutmaster Award of Merit Unit Leader Award of Merit Scouter’s Key Scouter’s Training Award Commissioner Arrowhead Honor Other Scouting Awards Type Year Type Year Type Year ACTIVITIES OUTSIDE OF SCOUTING

What is the most noteworthy service to youth made by this person that is beyond community or local council levels? (Please provide a detailed explanation.)

NOTE TO NOMINATORS: Please attach (digitally) no more than two letters of support with this nomination form when submitting. INSTRUCTIONS RULES AND REGULATIONS of the BOY SCOUTS OF AMERICA 1. This official nomination form must be used. 2. Give the nominee’s full name and title; avoid the Article XII, Section 6, Clause use of nicknames. 2 Silver Antelope Award 3. Provide as much information as necessary using the space provided on this form. No additional The Boy Scouts of America, acting through the documents should be attached other than National Court of Honor, may award the supporting letters of recommendation. Silver Antelope for distinguished service to youth Incomplete nominations will not be considered. upon the following basis and procedure: Supporting letters are accepted electronically and a) The award may be made each year upon the should provide supporting evidence of worthiness nomination of the regional cabinet. The to earn the award, not just include personal nomination shall be submitted not less than recommendations or endorsements. 30 days in advance of the date upon which 4. Nominations cannot be considered for it is desired to present the award. posthumous awards. b) This award may be made for noteworthy 5. Nomination forms with no more than 2 service of exceptional character youth by recommendation letters must be submitted registered Scouters, Cub Scouters, together electronically with this form to the Varsity Scouters, and leaders National Council at [email protected] no within the territory under the jurisdiction of later than November 30 for recognition for the a regional cabinet. following year. c) As evidence of the award there shall be presented a suitable certificate, duly authenticated by the Boy Scouts of Submit electronic nomination forms America, pursuant to the action of the and supporting documents to: National Court of Honor; and a miniature [email protected] Silver Antelope suspended by an orange, white, and orange ribbon to be worn around the neck. d) It shall be a general policy that no public announcements shall be made by the region in advance of action of the National Court of Honor with reference to the names presented for consideration. e) Each region is entitled to eight recipients per year. f) Unused allotments for any previous years may not be accumulated or used in any subsequent year. g) The National Court of Honor may, based upon initial recommendation of the Operations Group, award the Silver Antelope to persons in overseas area.

512-105 2018