Shofar Application Form
Nomination Procedure
1. Nominations may be made by Scouting volunteers or professionals.
2. The nominator must review the "Eligibility Guidelines" (see front page) and submit a letter of recommendation detailing
the nominee's qualifications.
3. The nominator must submit the application form to the local Jewish committee for approval.
4. The nominator must submit the application form to the local council for approval (the scout executive's signature is required).
5. The nominator must send in the completed application form, letter of recommendation, and payment of $36.00 payable to
P.R.A.Y. (8520 Mackenzie Road, St. Louis, MO 63123). Payment by check, money order, MasterCard or Visa is accepted. If
credit card please provide the following information:
Circle One: MasterCard Visa Acct Number:___ ___ ___ ___ - ___ ___ ___ ___ - ___ ___ ___ ___ - ___ ___ ___ ___
Expiration Date: ___ ___ / ___ ___ (MM / YY) Name on Card:________________________________________________
Cardholder’s Address:________________________________________Signature:__________________________________
6. Special shipping is available for an additional cost (visit www.praypub.org for current rates). After approval of the award,
orders will be delivered in 1 or 2 days depending on your zip code. A street address and day phone number are required. If
you want special shipping, please indicate below:
I request special shipping and authorize the additional charges.
Nominee
Name________________________________________________________________________________________________
(Printed exactly as it is to appear on the certificate)
Address ________________________________________________________________________________________________
City___________________________________________________________________State______Zip __________________
BSA Council ____________________________________________________________________________________________
Synagogue affiliation _____________________________________________________________________________________
Certification
In recognition of a major commitment to Jewish youth in Scouting, we recommend the nominee to receive the Shofar Award.
Chairperson, Awards Subcommittee _______________________________________________________________________
(or other Jewish Community Leader if there is no Awards Subcommittee Chairperson)
Chairperson, Local Jewish Committee _____________________________________________________________________
(or other Jewish Community Leader if there is no Local Jewish Committee on Scouting)
Scout Executive _______________________________________________________________________________________
Mailing Information
The Shofar award includes the medal, certificate and lapel pin.
Send Items To: Name _________________________________________________________________________________
Address _____________________________________________________________________________________________
City_________________________________________________________________State______________Zip____________
Phone (day contact)____________________________ Email __________________________________________________
Date of Award Ceremony ________________________
ADDRESS: P.R.A.Y. 8520 Mackenzie Road, Ste. 3, St. Louis, MO 63123-3413
PHONE:
1-800-933
-7729
FAX: 314-638
-7250
E-MAIL:
[email protected] WEB
: ww
w.praypub.org
No. 15-102 Prices Subject to Change – April 2006 Printing