2009 National Advanced Youth Leadership Experience Scholarship Request Form

Transcription

1 Central Region Boy Scouts of merica 2009 National dvanced Youth Leadership xperience Scholarship Request Form hilmont is offering 20 NYL Scholarships to the Central Region in 2009 to help Scouts with limited means to attend the NYL course. he course fee is $340 per person and the scholarship is for $200 per person. he National dvanced Youth Leadership xperience (NYL) is an exciting program where young men enhance their leadership skills in the hilmont Backcountry. Scouts will expand upon the team building and ethical decision making skills learned in National Youth Leadership raining (NYL). NYL uses elements of the hilmont Ranger raining as well as advanced Search and Rescue skills to teach leadership, teamwork and the lessons of selfless service. NYL will offer Scouts an unforgettable backcountry wilderness experience where they live leadership and teamwork, using the core elements of NYL to make their leadership skills intuitive. NYL is a training experience for youth leaders. It is conducted for older Scouts. Qualifications are: First Class rank or higher, 14 years of age by opening day of course, but not yet 18, proficiency in Scouting skills, and a hilmont Level Medical Form. he dates available for the NYL courses: June 14-20, 2009 June 21-27, 2009 June 27-July 3, 2009 July 4-10, 2009 July 12-18, 2009 July 19-25, 2009 July 26-ugust 1, 2009 ugust 2-8, 2009 o receive a NYL registration form, call hilmont raining Center at (575) Scout needs to send their application directly to hilmont as soon as possible. Receiving the scholarship does NO guarantee them a spot at hilmont. hilmont accepts applications on a first come, first served basis. Council Name / Number: Headquarter City / State: Scout needing assistance to attend NYL: Scout xecutive signature: Date: Return to: Jeff Stout.O. Box 3085 Naperville, IL Fax: (630)

2 HILMON RINING CNR BOY SCOUS OF MRIC National dvanced Youth Leadership xperience he hilmont leadership is committed to making NYL a very special experience. Scouts will live in a patrol setting at Rocky Mountain Scout Camp where they use their leadership skills to resolve exciting and challenging backcountry situations. he week will conclude with a closing challenge for each Scout to build upon the legacy of Waite hillips, the benefactor of the hilmont Scout Ranch. NYL will equip youth leaders to be better troop leaders, NYL staff members and/or superior camp staff. It will help guide their journey to become true servant leaders, able to develop all members of whichever team they lead. It provides life skills for now and the future. Requirements Successful completion of roop Leadership raining (L) ND National Youth Leader raining Be in top physical condition; a Class 3 Medical Form,completed within the past 12 months, is required (DO NO SND O HILMON, BRING H FORM WIH YOU) Be 14 years of age by the first day of your course, but not yet 18 Hold a troop leadership position Mission Statement he mission of the National dvanced Youth Leadership xperience (NYL) is to provide Scouts with a hilmont based wilderness encounter that motivates them to follow a life of helping others succeed based on the values expressed in the Scout Oath and Law. We accomplish this mission by: Creating an environment of learning and fun roviding a clear understanding of servant leadership in challenging wilderness environments roviding real life opportunities for ethical decision making, mentoring and living the Scout Oath and Law pplying all the leadership skills taught in NYL Objectives he National dvanced Youth Leadership xperience (NYL) is an exciting program where young men enhance their leadership skills in the hilmont Backcountry. Scouts will expand upon the team building and ethical decision making skills learned in National Youth Leadership raining (NYL). NYL uses elements of the hilmont Ranger raining as well as advanced Search and Rescue skills to teach leadership, teamwork and the lessons of selfless service. NYL will offer Scouts an unforgettable backcountry wilderness experience where they live leadership and teamwork, using the core elements of NYL to make their leadership skills intuitive. By the end of the NYL course, articipants should be able to: ncourage others to a life of Leadership Service ct as a Servant Leader who shares the skills of NYL and helps develop other leaders through their enhanced understanding of the material Institutively use the Leadership skills in all aspects of their lives Be an advocate for L and NYL in their local environment Use positive reinforcement to help others do their best rogram Costs he cost of the NYL program is $340. his fee covers meals/lodging beginning with lunch on the first day of your course and concluding with breakfast on the final day of your course, training materials, a NYL cap, and 2 NYL t-shirts. ayment schedule is as follows: $100 deposit due with application. he balance of the fee ($240) is due by June 1. ransportation and early arrival fees are additional.

3 HILMON RINING CNR BOY SCOUS OF MRIC ransportation ransportation is available from the lbuquerque airport; Raton, NM mtrak station and Greyhound bus depot; and the Cimarron bus stop. rior arrangement is necessary, additional charges apply. ransportation reservation forms will be included in your confirmation packet; do not make any transportation arrangements until your spot is confirmed. If you do not take one of these forms of transportation you are expected to arrive at the hilmont raining Center between 8:00 am and 10:00 am the day your course begins. If you chose to turn in your application 20 days before the course you need to include transportation information with the application, please contact the training center to get the appropriate forms NYL articipant Code of Conduct he general welfare of any group depends on the conduct of each individual member. his ensures the success of the NYL program and provides the maximum benefit to each participant. s a NYL participant, I understand this and support the reasonable demands of conduct expected of me. s a NYL articipant, I will: Live the Scout Oath and Law Observe, respect, and strive to live the Boy Scout Outdoor Code and hilmont Wilderness ledge Wear my full, official BS Field Uniform (khaki shirt w/ insignia, official olive shorts/pants, Scout belt, Scout socks) or proper clothing as required Be personally responsible for damage and loss of property Understand that theft, vandalism, or deliberate destruction of property, either of participants or hilmont is not permitted and will result in dismissal from the program at my own expense Respect all safety procedures and learn to properly use equipment t all times, be considerate of participants and staff of hilmont Scout Ranch hoto (alent) Release Statement I hereby assign and grant to the Boy Scouts of merica the right and permission to use and publish the photographs/film/videotapes/electronic representations and/or sound recordings made during my visit to hilmont Scout Ranch by the Boy Scouts of merica, and I hereby release the Boy Scouts of merica from any and all liability from such use and publication. I hereby authorize the reproduction, sale, copyright, exhibit, broadcast, electronic storage and/or distribution of said photographs/film/videotapes/electronic representations and/or sound recordings without limitation at the discretion of the Boy Scouts of merica and I specifically waive any right to any compensation I may have for any of the foregoing. By signing below, I acknowledge I have read and promise to abide by the code of conduct for the NYL program, have read and understand all the information about the NYL program as listed on this application, and agree with the hoto (alent) Release Statement. articipant s Signature Date arent/guardian Signature Date Visit us online at L S D O N O S R H I S L I C I O N.

4 HILMON RINING CNR BOY SCOUS OF MRIC 2009 National dvanced Youth Leadership xperience pplication Current Information lease clearly print all information requested. Name (first, MI, last) ddress City, State, ZI Home hone ( ) - Other hone ( ) - ge -Mail Date of Birth (mm/dd/yyyy) / / Nametag name (example Jonathan Jon, Matthew Matt) -Shirt Size S M L Scouting and Outdoor xperience Rank Unit No. Council # Council Name Leadership positions held Other leadership experience (school, religious group, etc.) revious hilmont experience Years Other High dventure xperiences (be specific) Honors/wards Received Leadership training (check all that apply): NYL articipant NYL Staff NJLIC articipant L articipant Other I refer the Following Session: (lease mark a first and second choice) NYL 1 (C Week 3, June 14-20) NYL 4 (C Week 6, July 4-July 10) NYL 7 (C Week 9, July 26-ug 1) NYL 2 (C Week 4, June 21-27) NYL 5 (C Week 7, July 12-18) NYL 8 (C Week 10, ug 2 ug 8) NYL 3 (C Week 5, June 27-July 3) NYL 6 (C Week 8, July 19-25) Letter of Recommendation lease enclose one letter of recommendation from someone you know well (other than a family member). his letter should describe why you would make a good participant in the NYL program. n application will only be considered with a letter of recommendation. FXD LICIONS R NO CCD S CC NUMBR CNNO B SCURD.

5 HILMON RINING CNR BOY SCOUS OF MRIC Beware of otential Risks hilmont offers High dventure backpacking treks and program activities in relatively inaccessible mountainous terrain. arents, advisors and youth participants should be alert to the potential for injury. hilmont strives to minimize risks to participants and advisors by emphasizing proper safety precautions. hilmont staff members will instruct all participants on safety measures to be followed. ach participant is expected to follow these safety measures and to accept responsibility for their health and safety. arent/guardian pproval My son has my complete permission to participate in the NYL program during the period indicated on this application. I have read and fully understand the information provided on this application and the enclosed Risk dvisory statement. I understand that the program is physically demanding and involves a degree of risk and a potential for injury. arent/guardian Signature Date Unit Leader pproval I attest this applicant is a member in good standing and approve his participation in the NYL program. Unit Leader Signature Date Local Council ction Council Name Council # We certify that (applicant s name) meets the age and physical requirements for the NYL program and is a registered member of the Boy Scouts of merica. he above listed council will / will not (circle one) pay for the applicant s program fees. Scout xecutive Signature Date ayment : otal Fee $ or Deposit w. pplication $ Final ayment June 1. lease select the appropriate method(s) of payment: Check (made out to hilmont Scout Ranch) Regional Scholarship($200) see local council for details (Must Fill Out Scholarship pplication and send with Registration pplication) Bill to Council (Must Fill Out Scholarship pplication and send with application) Credit Card (Mastercard, Visa, Discover ONLY) lease make checks payable to hilmont Scout Ranch and mail to: hilmont raining Center N: NYL rogram 17 Deer Run Road Cimarron, NM NO: Deposit fee, all required signatures and a letter of recommendation must accompany this application.

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7 NYL SCHOLRSHI LICION his application MUS be filled out if you are receiving a Council or Regional Scholarship and returned with your Registration pplication Form. hank you. Council Scholarship I certify that will receive a Council Scholarship in the amount of paid by the Council. By signing this form I agree that this amount must be paid by the council before the participant comes to the NYL program or the participant will be required to pay the course fees and be repaid by the council. articipant Signature: arent Signature: Scout xecutive Signature: Regional Scholarship I certify that will receive a Regional Scholarship in the amount of. By signing this form I have gotten this amount approved by the Region. articipant Signature: arent Signature: Scout xecutive Signature: Revised 2009