Merit Badge Counselor Application Form - Boy …

1 Boy Scouts of AmericaMERIT Badge Counselor INFORMATION(Please type or print.)Name _____ Age _____ Business phone (___)_____Address _____ Home phone (___)_____City _____ State _____ Zip code_____To qualify as a Merit Badge Counselor , you must Be at least 18 years old. Be proficient in the Merit Badge subject by vocation, avocation, orspecial training. Be able to work with Scout-age boys. Be registered with the Boy Scouts of a Merit Badge Counselor , I agree to Follow the requirements of the Merit Badge , making no dele-tions or additions, ensuring that the advancement standardsare fair and uniform for all Scouts. Have a Scout and his buddy present at all instructional sessions.

2 Renew my registration annually if I plan to continue as a meritbadge this subject in line with your job,business, or profession? If yes, givebrief information on the reverse you follow this subject as ahobby, having more than a workingknowledge of the requirements? Ifyes, give brief information on thereverse not, do you have any specialtraining or other qualifications forthis subject? If yes, give brief infor-mation on the reverse Merit Badge subjects ONE:nI wish to work only with wish to work with all _____Date_____Note: The BSA Adult Registration Application must be approval by _____ Date_____344051998 Boy Scouts of America10987654321 Unit number VocationAvocationSpecial trainingPostScript Picture730176344058#34405