APPLICATION FOR MERIT BADGE

Name Mady Godin
Address
City
Email
   is a registered scout of Troop 2
District Great Eastern
Council Sprite of Adventure
   I have discussed this merit badge with
   this scout and recommended at least
   one merit badge counselor.

Signature of Unit Leader Date
No.Letter CheckedInitial
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Issued by GSR Summer Camp 2022, Scouts USA               Incompleted       Hidden Valley Scout Camp - Week 7



The applicant has personally appeared before me and
demonstrated to my satisfaction that all requirements
have been met for the (please print)

Merit Badge Rifle Shooting
Counselor Tom Woithe
Address
Telephone number
Email address woithe@comcast.net

Signature

Date
Checked and recorded:
Date certificate and badge presented:
Applicant will turn this portion to his unit leader
for record posting.

 APPLICANT’S RECORD

Name Mady Godin
has given me this completed application for the
Merit Badge Rifle Shooting
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 Mady Godin
Unit Number Troop 2
Merit Badge Rifle Shooting
Date Completed

Remarks:

It is suggested that the counselor keep this
record in case any question is raised later in
regard to this award.
Issued by GSR Summer Camp 2022, Scouts USA               Incompleted       Hidden Valley Scout Camp - Week 7