River Valley District Boy Scout College Scholarship

Statement of Purpose This scholarship is established in order to honor a boy’s longevity and participation in Scouting. The Fall Merit Badge College at Hawkeye Community College has been a forum for boys to gain skills, knowledge, and crafts that will enhance their lives. To honor one young man who has stayed involved in Scouting through his High School years and continued his quest for skills, knowledge, and crafts during this time, we have established this $500 scholarship. The winner of the scholarship will be announced at the Fall Merit Badge College on November 5.

Requirements

• This scholarship is open to all boys who are currently registered with a Boy Scout unit that is part ofthe River Valley District of the Winnebago Council.

• Boys must be a graduating high school senior and entering a post-secondary institution in the fall of2017. Requests for exceptions (e.g. military training) must be submitted in writing with the application.

• Required components must be received by October 9, 2016 at the Winnebago Council Service Center: Completed application form High School transcript Copy of ACT and/or SAT scores Essay regarding your Scouting experiences (details on last page) List of merit badges with dates earned Letter of recommendation from Scouting Leader or Professional in sealed envelope Letter of recommendation from an individual in the academic field in sealed envelope

I hereby attest that all of the information I have submitted is accurate and true to the best of my knowledge.

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Signature Date

River Valley District Boy Scout College Scholarship

Applicant’s Information

Name _________________________________________________ Date of Birth ____________________

Phone Number ___________________ Street Address ___________________________________________

City______________________________ Zip _______________ Email _____________________________

Father/Guardian Name ____________________________________ Phone _________________________

Mother/Guardian Name ___________________________________ Phone __________________________

Name of High School _____________________________________ Dates Attended ___________________

Principal or Guidance Counselor _____________________________ Phone __________________________

Name of High School _____________________________________ Dates Attended ___________________

GPA ____________ on a scale of ___________ Class Rank ________ out of __________

SAT Score _____________ ACT Score __________ Anticipated Graduation Date ______________________

Please include a copy of your High School Transcripts and ACT or SAT scores.

Future Plans

Location

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Post-secondary Plans

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Anticipated Area(s) of Study ___________________________________________________

Future Career Interest(s) ______________________________________________________

Scouting Career

I am currently registered in Troop/ Crew __________ Charter Organization _________________________

Unit Leader _______________________________________ Phone _____________________

Years as a Cub Scout ______________________ Unit(s) and Council(s) _________________________

Years active in Boy Scouts _________________ Unit(s) and Council(s) _________________________

Years in Venturing _______________________ Unit(s) and Council(s) ________________________

Highest Rank Earned _____________________ Date __________ Number of Palms Earned _________

Title of Eagle Project (if earned) __________________________________________________________

Leadership Positions Held in Scouting (months held):

Patrol leader ________ Assistant Patrol Leader ________ Assistant Senior Patrol Leader ________ Senior Patrol Leader ________ Den Chief ________ Historian ________ Quartermaster ________

Chaplain’s Aide ________ Librarian ________ Scribe ________ Troop Guide ________ Junior Assistant Scoutmaster ________ Instructor ________ Bugler ________

Other (including Venturing roles)

OA Membership ________ Date of Ordeal ____________ Date of Brotherhood ___________ Vigil Honor ________

OA Leadership Positions Held

Scouting Honors and Awards (50 Miler, Historic Trails, Hornaday, Religious Emblems, etc.)

Camp Staff (location and dates)

Attendance at outdoor experiences of 5 days or more

Please include a list of all merit badges earned during your Scouting career. It is acceptable to use ScoutNet or a program like Troopmaster that lists the badges and dates earned.

Additional Life Experiences

School-related Activities Position Held

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Years Involved

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______________ ________________________________ You may attach additional sheets if you wish.

Community and Religious Activities Months Involved Position Held

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Places of Employment Months Employed Position Held

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Honors and Awards Received Outside of Scouting

Essay

Using at least one page, please answer one of the following questions. This essay should be typed:

• How has Scouting influenced your life and character?• What have you learned from your Scouting experience?