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
Use X for Middle Initial (Cannot be Blank)
*
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
Select
Small
Medium
Large
X-Large
XX-Large
XXX-Large
*
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
No Leading Zeroes... Use 7, NOT 007)
*
Council
*
District
*
Unit Type
Select …
Troop
Crew
Team
Ship
*
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
Select …
Totally Excellent
Pretty Good
Fairly Fair
*
My work ethic is
Select …
Totally Excellent
Pretty Good
Fairly Fair
*
My dependability is
Select …
Totally Excellent
Pretty Good
Fairly Fair
*
My leadership skills are
Select …
Totally Excellent
Pretty Good
Fairly Fair
*
My personal hygene is
Select …
Totally Excellent
Pretty Good
Fairly Fair
*
My Scout spirit is
Select …
Totally Excellent
Pretty Good
Fairly Fair
*
My personality is
Select …
Totally Excellent
Pretty Good
Fairly Fair
*
My attitude is
Select …
Totally Excellent
Pretty Good
Fairly Fair
*
My punctuality and timeliness is
Select …
Totally Excellent
Pretty Good
Fairly Fair
*
My self-motivation and initiative is
Select …
Totally Excellent
Pretty Good
Fairly Fair
*
My integrity is
Select …
Totally Excellent
Pretty Good
Fairly Fair
*
My ethical decision making skills are
Select …
Totally Excellent
Pretty Good
Fairly Fair
*
Skill Strengths
Lead discussion groups
Select …
Good at this
Handle this OK
Need more practice
*
Demonstrate scout-craft skills
Select …
Good at this
Handle this OK
Need more practice
*
Be a guide to others
Select …
Good at this
Handle this OK
Need more practice
*
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 following Staff-weeks
Week May 25-June 2
Week June 2-June 9
Week June 9-16
How did you hear about this course and why do you want to participate?
The commitment includes: 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).
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