Catholic Committee on Scouting
Diocese
of Brooklyn
THE BRONZE PELICAN EMBLEM
NOMINATION
FORM
.
Application Date____________________________________
(See Award Requirements before Completing
Nomination)
Name of Nominee _____________________________________________________________
Address of Nominee____________________________________________ City__________________, Zip_____________
Telephone Number of Nominee:________________________________________________
1. Catholic
Parish of Nominee:__________________________________________________
Parish Address_________________________________________________________________
2. Describe how the nominee has influenced the youth in Scouting which will indicate that he/ she is
a worthy candidate for the Bronze Pelican Award. Give concrete examples:________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
3. Indicate how the nominee has promoted participation of Scouts in activities for Catholic Scouts.
Give concrete examples.
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
4. Please provide any additional information which you believe to be pertinent as you nominate this adult for
the Bronze Pelican Emblem. __________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
5. Attach letter of recommendation from member of the Parish Staff.
Return
Nomination package (This form and $35.00 fee) to:
.
Mr.
Paul D. Stanton
