National Youth Leadership Training 2011
Atlanta Area Council, Boy Scouts of America
1800 Circle 75 Parkway, SE
Atlanta, GA 30339
Please register yourself
Choose the week you want to attend
First Preference
Must select the First Preference
Second Preference
Third Preference
Scout's general information
First Name
Middle Initial
Last Name
Suffix
Any suffix like Jr. or III should be added here.
Name on Name Tag
This is the first name you would like to be called by.
Example Jim or JT but not James Smith III
Birth Date
MM/DD/YYYY
(adult) T-shirt Size
Gender
Scout's Address Information
Street
City
State
Zip
Email
Scouting Related Information
Rank
Current Leadership Position
Unit Leader's Information - If Unit Leader is related to you choose an Asst. Unit Leader who knows you well
Unit Leader First Name
Unit Leader Last Name
Unit Leader Email
Unit Leader Telephone
###-###-####
Council
Select your council name
Other Council
If other - type Council name below
District
Select your District name - if the Council is AAC!
Unit Number
Unit Type
Applicant Information
Applicant Statement
Tell why you have decided to apply to the National Youth Leadership Training course and what you expect to gain from the course.
Physical Limitations
Give any Physical limitations or Restrictions
Medical and/or Behavioral Limitations
Give any Medical and/or Behavioral Limitations or Restrictions
Dietary Limitations
Give any Dietary limitations or Restrictions
Commitment
On my honor as a Scout I promise that I will faithfully live according to the Scout Oath and Scout Law during the National Youth Leadership Training and thereafter. I will represent my unit with honor and do all I can to pass on my knowledge and skills to my fellow Scouts. I am or will be by the beginning of the course at least 13 years old, have completed 7th grade and at least a First Class Scout (Venture exemption) and have successfully completed two week long summer camps. I understand that I must attend ALL course sessions in order to complete the course.
NYLT is not a week of summer camp. It is not free time. It is not an opportunity to earn merit badges. It is definitely not a vacation.
Commitment Check Box     
 By checking this box I understand and promise the above statements.
Parent SectionTo be filled by a parent
Accommodations
Scout -will- need accomodations for medical or physical or religious reasons
Medications - Prescriptions.
Scout may will have and may use the following Prescribed Medications
Special Requests or Information Regarding your Scout's Coping Stategies
Parent Name
Parent's Email
Daytime Telephone Number
###-###-####
Nighttime Telephone Number
###-###-####