Mission Peak 2016 Award Nomination Form
Each year, the Mission Peak District recognizes adult  _Cub,_Boy_Scout,_Venturer_and_Post Leaders at our annual recognition dinner in May. The attached form is your opportunity to nominate a fellow Scouter YOU feel is deserving of recognition. This year’s awards will be presented at the District Recognition dinner on _May_7,_2016_ in the Southern Alameda County Buddhist Church.  You will be notified if your nominee is selected for an award, so you can make sure the recipient and other troop/pack/crew/team members attend the presentation dinner.

AWARDS REQUIRING NOMINATIONS:
DISTRICT AWARD OF MERIT --- The district is allowed to present one to an individual for each 25 packs, troops or crews registered in the district as of December 31, 2015.  The current maximum is four.  Usually the individual recipient has received a Mission Peak Plaque and Certificate of Appreciation.  Each has displayed service of outstanding merit to a pack, troop, crew or the Mission Peak District for a considerable number of years.  

MISSION PEAK PLAQUE - The district awards ten plaques each year.  Occasionally one is awarded to a family or group.  Usually the recipients have received a Certificate of Appreciation.  Each has displayed service of noteworthy performance over a period of years.

CERTIFICATE OF APPRECIATION - Normally, Mission Peak awards 20 certificates each year.  They are presented in recognition of service to Cub Scout Packs and Dens, Boy Scout Troops, Venture Crews, Varsity Teams, Explorer Posts or on district and council activities.  

SPARK PLUG --- Each unit leader or committee chair s is encouraged to nominate a leader who has fired up or re- energized the unit.  No qualifying information is required.  

Nomination Rules:
1.   Please keep your nominations confidential.
2.   You may make copies of the attached forms.
3.   Attach additional sheets of paper if needed.
4.   Use a pen.
5.   You may submit the nomination on plain paper, computer facsimiles, or in any non- verbal method you select.
6.   You can use the form on the district website: http://www.sfbac.org/missionpeak.
7.   All nominees must be currently registered Scouters.
8.   Individuals may be nominated for more than one award.
9.  NOMINATIONS MUST BE RECEIVED NO LATER THAN THURSDAY APRIL 14, 2016.
10. The selection committee will use the provided information and readily available training and attendance records in considering qualifications for awards.
11. Please be as complete as possible.

MAIL NOMINATIONS TO:               Mission Peak Awards Selection Committee
1048 Bedford Street
Fremont, CA 94539

For additional information please contact:
Bruce Schlobohm (510) 301-0756 and/or bruce@troop176.us
Nominations may also be turned in at Roundtable on Thursday, April 14, 2016.

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Nominee Information
Nominee Name *
Name of the person you are nominating
Nominee Position *
Position with in the BSA your nominee holds
Unit Type *
What type of Unit is your nominee registered with
Required
Unit Number *
What is the number of the Unit your nominee is registered with
Years of BSA adult registration (if known):
Reason for nomination *
What has your nominee done to make your program more organized, more interesting, fun, or whatever term you might use to describe that special person who allowed your group to have a better, more quality Scouting program.  The more information the better.
Awards Earned
The following information will help the committee in deciding on the Plaque and Award of Merit. Please complete as much as possible and tell us whom we can telephone for more.
Cub Scout Awards
Check all that apply
Boy Scout / Varsity Awards
Check all that apply
Venturing / Sea Scouts Awards
Check all that apply
Other Awards
Check all that apply
Previous Scouting Experience / Other Service
Experience
Please specify Unit type and number, Position, and Number of years for each unit
Service to Youth in other organizations (PTA, Coach, school volunteer, etc)
About You
Your name *
Your unit *
Contact Phone Number(s) *
What number(s) can we best reach you if we have additional questions
e-mail address *
What is your e-mail address
Additional Contact
Who can we contact if additional information is needed?
Please specify Name, Unit, and contact number/e-mail
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