Print out and complete the form below and return to:

Sarah Mountain
Office for Parish Life
300 Wyoming Avenue
Scranton, PA  18503

Recommendation for the St. Elizabeth Ann Seton Emblem    

CANDIDATE  

NAME______________________________ 

NAME OF SPOUSE____________________  

ADDRESS___________________________________  CITY______________________

STATE______  ZIP______________

 

PARISH AND PARISH TOWN_________________________________________________  

REGISTERED IN SCOUTING AS______________________  COUNCIL___________________  

OCCUPATION AND EMPLOYER______________________________________________  

TELEPHONE NUMBER-HOME_______________________  WORK__________________  

 

PARISH APPROVAL

 

          On __________________, the candidate’s pastor _________________________ approved the candidate as worthy of receiving this emblem.  

                                                Signed_________________________________

 

*Please print date and pastor’s name and have pastor sign the bottom line.  

RECOMMENDED BY:  

NAME______________________________ HOME PHONE_______________________  

ADDRESS_____________________________  CITY___________________________  

STATE______  ZIP___________  DATE SUBMITTED____________________________


Scranton Diocesan Catholic Committee on Scouting
As offered through the Boy Scouts of America
Requirements for the Bronze Pelican Emblem Nominations:
 

1.       The candidate must be currently registered in Scouting, and must be able to verify a minimum of three (3) year’s service in the Scouting movement.  

          Registered since:                                            in the:

          (date)                                                 (council)  

          List the positions and honors received.  Attach additional sheet if necessary.

 

 

 

 

 

 

 

 

2.       Must have attended a Scouter Development Workshop within a three (3) year period or demonstrated personal growth through programs such as Woodbadge, Commissioner training, or Scouting activities of a nature to have shown personal growth.  

          List the names, dates and where and who presented:

 

 

 

 

 

 

 

3.       Must have been responsible for Catholic boys and girls working toward a Religious Emblem appropriate to their scouting age level or demonstrated a positive impact on Catholic youth through their adult leadership.  (Besides Religious Emblems Counselors, this requirement would apply to Scout leaders or Unit Committee Members of a Catholic or Non-Catholic unit, District or Council level leaders or committee members, who can demonstrate they have assisted Cubs, Scouts or Explorers in the successful completion of religious emblem work.)  

          List the year, unit, number of recipients, emblem received, or state specific impact actions:

 

 

 

 

 

 

 

 

 

 

 

Provide any additional information about the nominee that you feel would be of interest to the Selection Committee.  Use additional paper if needed.  

Any Scouter through the Diocesan Catholic Committee on Scouting may submit nominations for this award.  These requirements are set forth by the Scranton Diocesan Catholic Committee on Scouting and may be modified by this committee although no honorary awards will be given.  

The Scranton Diocesan Catholic Committee on Scouting has agreed to honor a maximum of 5 adults per year with the Bronze Pelican Emblem.  Please know that each nominator will be notified of the status of the application submitted.

 

Council Approval

  

  Signed__________________________________________ Date__________________

  Chairman, Catholic Committee Council

 

Diocesan Approval  

 

  Signed________________________________________

Date __________________

  Chairman, Selection Committee  

  Signed_________________________________________ Date___________________

  Chairman, Diocesan Committee  

 

  Signed_________________________________________ Date___________________

  Chairman, Scout Chaplain