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

First Name
* shows required information
*
Middle Initial *
Last Name *
Your Preferred Name *

Gender
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
*
T-Shirt size *
Parent/Guardian Information
Parent/Guardian Name *

Parent/Guardian Phone
Use format XXX-XXX-XXXX
*
Parent/Guardian email *
Your current level/interests
Grade level in school *
List your sports, school, religious, community and other activities
List your hobbies and other interests
List any special skills and certifications you hold
Troop Information
Unit Number *
Council *
District *
Unit Type *
Current Rank *
Present Position *
Other positions you have held
Achievements
List any scouting awards you have received
Summer camps, high adventure bases, and Jamborees you have attended
Troop level training you have attended
Council level training you have attended *
The year of your course *
If you ever staffed NYLT course, what position(s) did you hold?
Philmont advanced leadership training experience(s)
Who I am
My uniform neatness, correctness, and completeness is *
My work ethic is *
My dependability is *
My leadership skills are *
My personal hygene is *
My Scout spirit is *
My personality is *
My attitude is *
My pucntuality and timeliness is *
My self-motivation and initiative is *
My integrity is *
My ethical decision making skills are *
Skill Strengths
Lead discussion groups *
Demonstrate scoutsraft skills *
Be a guide to others *
Personal Information
     
 Have any Physical, Medical, Dietary limitations or Restrictions?
Restrictions or Limitations
I am available for the following weeks:

     
Choose at least one of the weeks
Week May 27-June 4
     
 Week June 4-June 11
     
 Week June 11-18
How did you hear about this course and why do you want to participate?
The commitment includes: Dec 12, 2010 Staff Interviews, Jan 22 Staff Orientation; Staff Development Weekends Feb 26, Mar 18-20, Apr 22-24, course set-up May 21, the full week of a course May 27-June 4, June 4-11 OR June 11-18 and for all final turn in of all equipment on June 18, 2011.