APPLICATION FOR MERIT BADGE

Name Benjamin Freemerman
Address
City
Email
   is a registered scout of
District
Council
   I have discussed this merit badge with
   this scout and recommended at least
   one merit badge counselor.


Signature of Unit Leader Date

Issued by Daniel Webster Council, Scouts USA                 



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
Telephone number
Email address taewonjin@Phoenixbc.com

Signature

Date

8/12/2022

Checked and recorded:
Date certificate and badge presented:

Applicant will turn this portion to his unit leader
for record posting.

APPLICANT’S RECORD

Name
has given me this completed application for the
Merit Badge
Completed on



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:


It is suggested that the counselor keep this
record in case any question is raised later in
regard to this award.

Issued by Daniel Webster Council, Scouts USA