National Eagle Scout Association
The Glenn A. and Melinda W. Adams National Eagle Scout
Service Project of the Year Award
Name ________________________________________________________________________________________________________________________________
Home address ____________________________________________________________________ E-mail address _____________________________________
City _____________________________________________________________________________ State _____________ Zip ____________________________
Parent or guardian ______________________________ Home phone No. _____________________ Board of review date ____________________________
Council headquarters city _______________________________________________ Council No. __________________
Region (check one) N C S W
Nominated by _________________________________________________________________________ Phone No. ____________________________________
Name of service project ________________________________________________________________________________________________________________
Project summary (a short, concise description)
Project website/other online references (if applicable):
ScouT’S coNSENT
I hereby consent to the submission of my Eagle Scout leadership service project for consideration of this award.
Scout’s signature _________________________________________________________________________________ Date
_____________
couNcil APProvAl
The
Council NESA Committee has selected
as
___________________________________________________
___________________________________
recipient of the Council Eagle Scout Service Project of the Year Award. We hereby submit this nomination to the regional
selection committee for consideration as recipient of the Regional Eagle Scout Service Project of the Year Award.
Date
Date
_________________________________________
_____________
_________________________________________
_____________
NESA committee chair
Committee staff adviser
rEGioNAl APProvAl
The
Region NESA Committee has selected the nominee on this form as recipient of the
_______________________________________________
Regional Eagle Scout Service Project of the Year Award. We hereby submit this application to the national NESA Committee
for consideration as recipient of the Glenn A. and Melinda W. Adams National Eagle Scout Service Project of the Year Award.
Date
Date
_________________________________________
_____________
_________________________________________
_____________
NESA committee chair
Committee staff adviser
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