Spreadsheet: 3651b5dd-c7ed-46ef-ae2e-2f238400bf57
Sheet: Sheet1

[NAME] – NCAC - BSA | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Unnamed: 8 | Unnamed: 9
Scouter Personnel Summary Sheet and Resource Survey
Please fill out this sheet, printing clearly. This information will be used to better take advantage of talents
and resources of Scouters in the Patriot District and to serve as a guide in the selection process for District
Awards. Substitute layouts containing the same information are acceptable.
I. Personal Information
Last Name |  |  | First Name |  |  | MI |  | Spouse's Name
Address
City |  |  | State |  | Zip |  | E-mail
Home Phone |  |  | Business Phone |  |  |  | Fax
Employer |  |  |  |  | Occupation
Higher Education (School and Degree) |  |  |  |  |  |  | Date of Birth
Religions Affiliation (Parish, Church, Synagogue)
II. Scouting Record
Current Scouting Position |  |  |  |  | Highest Rank Earned as Youth
Pack # |  | Troop # |  | Team # |  | VenVar# |  | [NAME].
Years in Scouting as: |  |  | Boy |  | Girl |  | Adult
[NAME] of Scout Service and Experience
List all Records of Unit, District, Commissioner, Council Service; Experience in Events, Activities, or Projects
Position/Staff |  |  | Unit #/Event Name |  |  | District/Council |  |  | Dates
B. Activities Outside of Scouting (Youth, Church, Civic, Fraternal, Professional or Business)
Organization |  |  | Address |  |  | Position/Service |  |  | Dates
[NAME] Leader [NAME]
Type |  |  | District/Council |  | Dates |  |  | Position At Time
Youth Protection
This is [NAME]
New Leader Essentials
Pack Committee Fast Start
Tiger Cub Fast Start
Cub Scout Fast Start
Club Scout Basic/Ldr. Specific
[NAME]
Troop Committee Challenge
[NAME]
Scoutmaster Fundamentals
Scoutmaster/ASM Specific
Intro. Outdoor Leadership Skills
Varsity/Venture Fast Start
Varsity/Venture Ldr Specific
Commissioner [NAME]
Commissioner Basic
Commissioner College
COR Fast Start
Chartered Org. Rep. [NAME]
Train the Trainer
Pow Wow
Philmont |  |  |  |  | Course and Date?
University of Scouting |  |  |  |  | Course and Date?
Other (Please List)
Other (Please List)
Woodbadge Courses
Cub Scout Course # |  |  |  | Where? |  |  | Date Beads Presented
Boy Scout Course # |  |  |  | Where? |  |  | Date Beads Presented
New Woodbadge # |  |  |  | Where? |  |  | Date Beads Presented
Staff Position |  |  |  | Where? |  |  | Date Beads Presented
D. Awards and Recognition |  |  |  |  |  |  |  | III. Special Skills
Type of Award |  | Position |  | District/Council |  | Date |  | Identify how you can help
[NAME] Awards |  |  |  |  |  |  |  |  | Crafts
Minute [NAME] |  |  |  |  |  |  |  |  | Outdoor Skills
[NAME] |  |  |  |  |  |  |  |  | Fund-Raising
Distinguished Patriot |  |  |  |  |  |  |  |  | Computer Skills
Award of Merit |  |  |  |  |  |  |  |  | Truck or Van
[NAME] |  |  |  |  |  |  |  |  | Power Tools
[NAME] |  |  |  |  |  |  |  |  | Organizer
Commissioner[NAME] |  |  |  |  |  |  |  |  | Administrative
Other |  |  |  |  |  |  |  |  | Trainer
Other |  |  |  |  |  |  |  |  | Public Speaker
Order of the Arrow | Ordeal Date |  | Brothd Date |  | Vigil Date |  |  |  | Other:
 | Current Chapter and Council |  |  |  |  |  |  |  | Other:
Signature |  |  |  |  |  |  |  | Date
Return Copy of Completed Form to [NAME], [EMAIL]