Diocese of Brooklyn Catholic Committee on Scouting

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2019 St. Anne Award Nomination Form

Diocese of Brooklyn

Catholic Committee on Scouting

 

MUST be returned to the CCOS no later than Friday, April 5, 2019

 

ABOUT THE NOMINEE:

 


Name                                                                                                                                                                                

Parish                                                                                                                                                                               

Address                                                                                                                                                                             

City/State/ZIP                                                                                                                                                                   


T
elephone                                                                          E-mail                                                                          

 

(1)   Years as an Adult Member   ________

   Indicate years with: Girl Scouts_______ Camp Fire _______ Other______________

 

(2)   Position(s) Held Now:

 

 

 

(3)   Positions Previously Held in Girl Scouts/Camp Fire/Other:

 

 

 

(4)  Please state specifically what contributions the candidate has made in the spiritual development of Catholic members in the above organizations that would merit this award:

 



 

 

(5)  Please record other contributions of the candidate, with positions held and dates, specifically in regard to the activities of the parish, diocese, organization served (Girl Scouts, Camp Fire, Other), business, civic, religious, educational organizations.

 




 

 

ENDORSEMENT

 

I hereby affirm the nomination of                                                                                      as worthy of this recognition.

 


_______________________________________________                    ____________________

Signature of Parish Priest/ Pastor/ Moderator                                                            Date

 

 

 

ABOUT THE NOMINATOR:

 

Name                                                                                                                                                                


Position                                                                                                                                                            



Address                                                                                                             

 

 

City/State/ZIP                                                                                                   

 

Telephone                                             E-mail                                                

 

Date                                                                                                                

 

Note: Nomination is to be kept confidential. The person making the nomination will be notified of the results. Awards are presented at the Bishop’s Dinner for Scouting.  Congratulatory messages may be sent for publication in the Dinner Journal.  

 


Send form to:  


Paul D. Stanton, Chairman

Catholic Committee on Scouting, Diocese of Brooklyn

2 Hinckley Place, 1L

Brooklyn, N.Y.  11218

 

 

Award payment check in the amount of $35. should be made payable to CCOS and mailed to above address.

 

Questions:  Pdstanton@aol.com

347-446-8608 (cell)

718-438-4575 (h)