Moecomdws District Awards Nomination Form

Awards to be presented at District Annual Recognition Event in April

Nominee to be considers for:

(check one) ___ Cub Scout Spark Plug Award ___ Partners in Scouting Award ___ Boy Scout Spark Plug Award ___ Helping Hand Award ___ Venturing Spark Plug Award ___ George C. Eisenman Award Name: _________________________________________________________________ Address: _______________________________________________________________ City: ______________________________ State: ___________ Zip: ______________ Registered in Scouting as: ___________________________________________________ If Scouter is unit connected, unit number: ______________________________________ Submitted by: _____________________________________________________________ Telephone No.: __________________________________ Date: _____________________

In your explanation of the candidate’s qualification, please

do not

use the person’s name or unit number in the narrative section. This enables the award committee to focus on theaccomplishments of the person, not the personality.

Send completed nomination forms to: Shannon Sinex, Great Trail Council, BSA, P O Box 68,Akron, OH 44309-0068, fax 330-773-4084, e-mail ssinex@bsamail.org

This form must be returned to Scout Service Center by March 31, 2010

W/Moe/District Awards Nomination Form

Please state why you feel this person should be considered: (Attach additional sheets, if required)