To Join the Diocese of Brooklyn Catholic Committee on Scouting
complete and submit this application form :
-------------------------------------------------------------------------------------------------------------------
2018 -2019 Application for CCOS Membership
Please attach a copy of
your Scout registration card, Youth Protection Card, Virtus Training Card, a letter from your Parish Pastor stating that you
are a practicing Catholic and registered parishioner. Committee members will receive a Catholic Committee Patch and Membership
Card.
Please Print and Provide All
Information:
Applicant's Name________________________________________________________________________
Applicant's Address______________________________________________________________________
City, State, Zip + 4 Code_________________________________________________________________
Tel: (H)____________________(W)______________________ (Cell)_____________________________
Email_________________________________________________________________________________
Home
Parish__________________________________________________________________________
Address of
Home Parish_________________________________________________________________
Scouting Unit
#: Pack______, Troop_____ Crew_____ Girl Scout Troop #______
Unit Sponsor:__________________________________________________________________________
Sponsor's Address______________________________________________________________________
Unit
Meeting Time and Day_______________________________________________________________
Unit/
District/ Council Position Held_________________________________________________________
Name
of Scouting District/ Service Unit______________________________________________________
Date
last completed Youth Protection________________, Virtus Taken____________________________
I am willing to serve on the following committee or event staff:(Circle one or more)
[
] Virtus Youth Protection Trainer, [ ] Catholic Scouter Development Trainer, [ ] Membership, [ ] Youth Religious Emblems
Counselor,
[ ] Convocation Event, [ ]Bishop's Dinner,
[ ]Peacelight Arrival and Diocesian Distribution, [ ]CCOSBQ Web site contributor,
[ ]Communications, [ ] Catholic Scout Unit Commissioner, [ ] Retreat, [ ] Adult Recognitions,[ ] Chaplain,
[ ] Event Photographer,
[ ] Scout Sunday, [ ] Bishop's Gold and Eagle Award Certificate
Presentations [ ] Other Volunteer Interests or Skill :_____________
Mail
Completed Application to :
Paul D. Stanton
Chairperson,
Catholic Committee on Scouting
Diocese
of Brooklyn & Queens
2 Hinckley Place, 1L
Brooklyn,
N.Y. 11218
