Adult Troop/Crew Leader Application Form – Part 1 Northeast Region

Notes: Before applying, please review the selection criteria. We anticipate numerous applicants; if you do not meet most of the criteria, please do not apply. Remember to make a copy for your file. For NER Lead SMs and Crew Leaders and Assistants, use this form to apply. Deadline: 2/15/14

Name:
(Please Print or Type)

Address: City: Home Phone: ( E-mail: Region: Northeast ) State: Zip: Business/Cell Phone: ( Birthday (mo/day/yr): Your Council # & Headquarter City: ) Age:

Qualifications: 1. Prior World Scout Jamboree leader? If yes, position, year and country:

2.

Prior National Jamboree leader? If yes, position and year:

3.

Experience as troop Scoutmaster/Crew Leader? If yes, unit number, years and currently Scoutmaster/Crew Leader:

4. 5. 6.

Excellent health and fitness: Wood Badge trained? If yes, year: Foreign travel experience? If yes, where and when (if travel frequently, list various examples):

7. 8. 9.

Will you have a son or daughter applying to attend? Are you able to commit the time for pre-jamboree development of a unit? List other qualification relating to the leadership criteria that would make you a good candidate for troop/crew leadership in 2015(attach a separate typed sheet if necessary):

Submit to: (Email is Preferred)

Mark Kriebel NER WSJ Chairman 400 Sunrise Drive Endwell NY 13760 markkriebel@prodigy.net

or

Jim Hans NER WSJ Regional Coordinator 1325 W. Walnut Hill Lane Irving, TX 75038 jim.hans@scoutiing.org

Part 1: The Northeast Region application deadline for consideration is 2/15/14; do NOT send any fees with this application. Send this NER application to Mark and to Jim. Part 2: Applicants may apply at www.scouting.org/worldjamboree. Applications must be approved by the applicant’s local council and region. Jamboree fee payments will be made online through the same link.

Sign up to vote on this title
UsefulNot useful