National Youth Leadership Training
Atlanta Area Council, Boy Scouts of America
1800 Circle 75 Parkway, SE
Atlanta, GA 30339
NYLT Scouter Staff Application
Scouter Information

First Name
* Shows Required I nformation
*
Middle Initial
Use X for No Middle Initial
*
Last Name *
Your Preferred Name *

Gender
Use M or F
*
Address
Street *
City *
State *
Zip *

Home Telephone
Use format XXX-XXX-XXXX
*

Mobile Telephone
Use format XXX-XXX-XXXX
Email Address *

Date of Birth
format it as mm/dd/yyyy
*
Unit Information
Unit *
Unit Type *
District *
Present Position *
Attended High Adventure
     
 Philmont
     
 Sea Base
     
 Northern Tier
     
 Other
Number of years in Boy Scout Program

Unit Leader
How many years? 0 or more

Asst. Unit Leader
How many years? 0 or more

Other
How many years? 0 or more
Personal Information
     
 Have any Physical, Medical, Dietary limitations or Restrictions?
Restrictions or Limitations
T-Shirt size - Adult Sizes *
Desired position to fill – check all that apply
     
 Course Director
     
 ACD – Program
     
 ACD – Service
     
 Support Staff
Your Availability

     
Pick at least one Staff-week
Week May 25-June 2
     
 Week June 2-9
     
 Week June 9-16
Any schedule conflicts we should know about?
How did you hear about this course and why do you want to participate?
How do you rate your working relationship with teenage scouts? *
The commitment includes: September 24, 2011 - Course Directors Conference; November 12, 2011 - Adult NYLT Training; December 18, 2011 - Staff Interviews VSC; January 21, 2012 - Staff Orientation VSC; Staff Development Weekends - Feb 25 VSC, Mar 23-25 BASR, Apr 20-22 BASR; Course Set-up - May 19; the Staff-week of a course May 25-June 2, June 2-9, OR June 9-16; and for the final camp tear-down and turn-in of all equipment on June 16, 2012 (9am-4pm).
     
 Attended Wood Badge?
Course Number
Year
Location
     
 Staffed Wood Badge?
Course Number (any one)
Year
Location
Position
     
 Staffed JLTC / NYLT?
Position
Year(s)
Location(s)
     
 Attended NYLT Course Directors Conference?
Year
Location
     
 Attended Trainer Development / Trainer EDGE?
Year
Location