The applicant has personally appeared before me and
demonstrated to my satisfaction that all requirements
have been met for the (please print)
| Merit Badge |
|
| Counselor |
|
| Address |
|
| |
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| Telephone number |
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| Email address |
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Signature |
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Date |
8/12/2022 |
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| Checked and recorded: |
| Date certificate and badge presented: |
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Applicant will turn this portion to his unit leader
for record posting.
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APPLICANT’S RECORD
|
| Name |
|
| has given me this completed application for the |
| Merit Badge |
|
| Completed on |
|
|
|
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| Signature of counselor |
|
|
| Signature of unit leader |
|
NOTE TO SCOUT, VENTURER, OR SEA SCOUT:
Retain this copy for your permanent record.
|
COUNSELOR’S RECORD
|
| Applicant |
|
| Unit Number |
|
| Merit Badge |
|
| Date Completed |
8/12/2022 |
Remarks: |
|
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It is suggested that the counselor keep this
record in case any question is raised later in
regard to this award.
|