"Scholarship Application Form - High Adventure & Training - Boy Scouts of America"

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Great Lakes Field Service Council
Boy Scouts of America
SCHOLARSHIP APPLICATION - HIGH ADVENTURE & TRAINING
st
Applications are reviewed quarterly and must be submitted on the 1
of the Month (March, June, September, &
December) to be reviewed later that same month. Scholarships will be awarded based on a portion of the total
cost as posted on the registration website (the amount will vary based on event).
Personal Information
High Adventure/Training
Check One Below
Name _______________________________________________________
Powderhorn
NOAC
Parent/Guardian Name:__________________________________________
Philmont
NAYLE
Sea Base
NYLT
Address ______________________________________________________
Sea Badge
IOLS
Summit
SEAL
City, State, Zip _________________________________________________
Wood Badge
National Jamboree
Adult Email : __________________________________________________
Training Centers
Northern Tier
Birth Date ________________ Adult Cell Phone# _____________________
Other:
Unit Type & # ____________ District __________ Rank/Position _________
High Adventure/Training Information (Event)
Event Name & Number: ____________________________________________ Year Attending:___________
Already registered for the event w/ deposit? Yes or
No
If Yes, provide event registration number: ____________________________________________________
Scholarship will only be awarded through active registrations
If No, you will need to register before the event scholarship can be applied
Reason for Scholarship
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ScholarshipApplicationHA-T
Great Lakes Field Service Council
Boy Scouts of America
SCHOLARSHIP APPLICATION - HIGH ADVENTURE & TRAINING
st
Applications are reviewed quarterly and must be submitted on the 1
of the Month (March, June, September, &
December) to be reviewed later that same month. Scholarships will be awarded based on a portion of the total
cost as posted on the registration website (the amount will vary based on event).
Personal Information
High Adventure/Training
Check One Below
Name _______________________________________________________
Powderhorn
NOAC
Parent/Guardian Name:__________________________________________
Philmont
NAYLE
Sea Base
NYLT
Address ______________________________________________________
Sea Badge
IOLS
Summit
SEAL
City, State, Zip _________________________________________________
Wood Badge
National Jamboree
Adult Email : __________________________________________________
Training Centers
Northern Tier
Birth Date ________________ Adult Cell Phone# _____________________
Other:
Unit Type & # ____________ District __________ Rank/Position _________
High Adventure/Training Information (Event)
Event Name & Number: ____________________________________________ Year Attending:___________
Already registered for the event w/ deposit? Yes or
No
If Yes, provide event registration number: ____________________________________________________
Scholarship will only be awarded through active registrations
If No, you will need to register before the event scholarship can be applied
Reason for Scholarship
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ScholarshipApplicationHA-T
Great Lakes Field Service Council
Boy Scouts of America
Financial Breakdown
Instructions: Add Lines B, C, & D (Total Available Contribution Toward Cost) Subtract Line E from A (Total
Cost of Event = Amt. Of Scholarship requested.
A. Total Cost of High Adventure/Training
$ ________
B. Family/Individual Contribution
$ ________
C. Scout’s Earned Contribution
$ ________
D. Unit, Chartering Organizations, Community or Civic Group Contribution
$ ________
E. TOTAL AVAILABLE CONTRIBUTIONS (add lines B,C,D)
$ ________
F. SUBTRACT LINE E FROM A= FINANCIAL NEED
$ ________
AMOUNT OF SCHOLARSHIP REQUESTED……………………………………...$ ________
I affirm that I have a real need for this scholarship. I promise that I will do my best to complete the trip and/or
all training course requirements. I understand that in the event that I am unable or unwilling to complete the
trip and/or training course, I will be required to repay any scholarship monies received.
Signature: _______________________________________________________ Date: ________________
Parent Signature: __________________________________________________Date:________________
(if applicant is under the age of 18)
Leader/Mentor Signature ____________________________________________Date: ________________
(Only needed for youth applicants)
Form Completed By: _______________________________________________ Date: ________________
(if different than applicant/parent)
For Statistical Purposes Only
What was the date of your unit’s Friends of Scouting (FOS) presentation? _____________________________
Scout or Leader (with your unit) participated in the council fundraisers
Spring Sale? Yes or No / Fall Sale? Yes or No
What summer camp was most recently attend? __________________________ What year? ___________
Applications are only to be submitted via email to ScholarshipGLFSC@scouting.org
Council Use Only
Amounted Awarded________________________
Date Posted to Registration:_______________________
Approved By:_____________________________
Approved Date:___________________________
Scholarship Fund Used:___________________________
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