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Wait to fill out when undated to 2022
SCOUT APPLICATION 2021
and leadership request form
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Required field
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Indicates required field
Your Formal Name
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First
Last
First Name you are know by:
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Home Troop #
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Enter T-xxxx, where xxxx is your Troop Number
Scouts Phone Number
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Can we text this number?
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YES
NO
School Attending
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Scouts Email:
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Choose how old will you be on May 24, 2021?
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Less than 13 (Will be concidered only if not enough 13-17)
13
14
15
16
17
How many years of MISST service.
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NEW
1
2
3
4
5
6
7
What years did you provide MISST service?
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Example: 2015, 2016, 2017. NA if new.
Birth Date
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Month
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January
February
March
April
May
June
July
August
September
October
November
December
Day
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1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
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30
31
Year
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2003
2004
2005
2006
2007
2008
2009
2010
ADDRESS
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Line 1
Line 2
City
State
Zip Code
Country
List any Medical, Dietary, or Food allergy we should be aware of.
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Why have you decided to participate in the Mackinac experience?
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What do you expect to gain from the experience?
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Current Rank
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List Leadership Positions held in your home troop
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Order of the Arrow Membership and offices
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RANK Expected on May 24, 2021.
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Scouting Awards
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Scouting Training (Courses taken and dates)
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List any ather Extra Curricular Activities and other Organizations and Positions you have held.
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List past positions held with MISST if any.
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NA if you did not hold a position.
1st Alternate Phone Number
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Can we text this number?
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YES
NO
1st Altenate Phone Number belongs to:
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2nd Alternate Phone Number
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Can we text this number?
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YES
NO
2nd Alternate Phone Number belongs to:
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Fathers name:
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First
Last
Father's Email
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Mother's Name
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First
Last
Mother's Email
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Home Scoutmaster's Name
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Scoutmaster's Phone Number
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Who was the influencing person who encouraged you to apply this year for our troop?
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Check if you are you certified in:
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CPR
First Aid
Are you interested in serving on the Quartermaster Corp.? Boys with at least one year of MISST service ONLY
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Yes
NO
Do you Play any of these?
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Bugle
Trumpet
Drums
If you play any of these check if want to be in:
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The Drum and Bugle Corp.? Anyone who plays a drum or bugle (trumpet)
The Drum and Bugle Patrol? (Must have one year of MISST service.)
ALL YOUTH: The information above is required for all applying to go to Mackinac Island for this season.
Complete the information below only if you are applying for a LEADERSHIP position.
If you are not applying for a Leadership portion skip to the bottom
and click on the submit button.
Choose your 1st choice Leadership Position for which you are applying.
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Senior Patrol Leader
Assistant Senior Patrol Leader
Patrol Leader
Assistant Patrol Leader
Drum & Bugle Corp. Patrol Leader
Drum & Bugle Corp. Assistant Patrol Leader
Quartermaster Patrol Leader
Quartermaster Assistant Patrol Leader
Buglar
Chaplain Aide
Marching Instructor
Flag Instructor
Scribe
Historian
Why do you want to hold this position? What are you qualifications?
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Check all postitions you would be willing to hold.
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Senior Patrol Leader
Assistant Senior Patrol Leader
Patrol Leader
Assistant Patrol Leader
Drum & Bugle Patrol Leader
Drum & Bugle Assistant Patrol Leader
Quartermaster Patrol Leader
Quartermaster Assistant Patrol Leader
Bugler
Chaplain Aide
Marching Instructor
Flag Instructor
Scribe
Historian
What are your qualifications for these Positions?
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ADDITIONAL INFORMATION
Make any additional comments and/or upload a more detail letter.
Comment
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Submit