Get documents about "DocDownload
Document Sample
TO SPEED UP THE CERTIFICATION PROCESS AND HELP REDUCE ERRORS, PLEASE SAVE A COPY OF THIS
COMPLETED FILE TO A CD AND INCLUDE THE DISK IN YOUR EAGLE PACKET.
INSTRUCTIONS FOR USING THE ELECTRONIC EAGLE APPLICATION 2011 ver 1.0
This Electronic Eagle Application was originated by Larry Morris of the Grand Canyon Council with, guidance
from Paul Wolf of the U.S. Scouting Service Project (USSOP), to provide Eagle Scout Rank Candidates and their
adult leaders with a tool to prepare an error free Eagle Scout Rank Application . In 2006, Sohail Hussain, also of
Grand Canyon Council, converted the Candidate Data worksheet to questionnaire format and made numerous
other enhancements. Thanks also to Larry Lynn of the Northeast Georgia Council and many Grand Canyon
Council Scouters who have contributed enhancements and provided feedback.
This workbook consists of this Instruction Tab plus 7 additional Tabs.
Instructions:
1) Enter all data in the worksheet tab labeled "Candidate Data"
•If you see a popup message “For District or Council Use Only”, leave that cell blank. You will also see
numerous popup messages to alert you of errors to be avoided or corrected, available options, and
detailed instructions.
•All Candidate Data sheet dates must be entered in MM/DD/YY format but will convert to month, day, and
year format. If they don’t convert, there is some sort of data entry error.
•Enter numbers only, with no spaces or punctuation, for phone numbers. They will be properly formatted
automatically.
•LDS Scouts are typically registered as Boy Scouts on their 11 th birthday, as Varsity Scouts at 14, and as
Venturers at 16. Aswering the question "Is this an LDS Unit" by selecting Y in the appropriate cell (D18)
will automatically fill in those joining dates for LDS Scouts if they meet the joining requirements for each
type of unit. If the actual dates differ, the automatic dates may simply be typed over as required.
•All Merit Badges are now selected from pull down lists to ensure accuracy.
•If more than one of the listed merit badges was earned for badge number 6, select the one not used for
Eagle, as number 19 to be counted as a required badge for ranks earned prior to Eagle.
•If more than one of the listed merit badges was earned for badge number 9, select the one(s) not used for
Eagle, as number 20 and/or number 21 to be counted as a required badge for ranks earned prior to Eagle.
•Only two leadership positions may be listed on the Eagle application and the dates must be while a Life
Scout and before turning eighteen. The leadership dates may not overlap. Please list the earliest position
first under Leadership Information.
2) View cell (A78) in Candidate Data for any "ERROR" messages.
3) Correct errors before proceeding.
4) View the Merit Badge tab for any "ERROR" messages.
5) Correct errors before proceeding.
6) View the Date Checks tab.
7) Correct errors before proceeding.
8) View the Check Sheet tab. Section 1 is for council use only. Cells in Column A with a yellow background,
labeled “Not Checked” indicate items that must be verified manually.
9) Correct any errors before proceeding.
10) Print the Eagle Application back-to-back and head-to-head just like the BSA application form.
Front Paper tray inkjet type printers:
Print page one, rotate page 180 degrees (do not flip over) and return page one to paper tray, print page 2.
Top paper tray inkjet type printers:
Print page one. Flip paper over (do not rotate) and return page one to paper slot, print page two.
11) Obtain proper signatures. A parent or guardian may not sign the Eagle Scout Rank Application.
12) Complete the rest of your eagle packet, then answer the questions in the rest of the Candidate Data
worksheet. Leave the District Certification section blank.
13) View cell (A98) in Candidate Data for any "ERROR" messages.
14) Correct errors before proceeding.
15) Print out the rest of the sheets from this Excel workbook to include in your packet
TO SPEED UP THE CERTIFICATION PROCESS AND HELP REDUCE ERRORS, PLEASE SAVE A COPY OF THIS
COMPLETED FILE TO A CD AND INCLUDE THE DISK IN YOUR EAGLE PACKET.
Candidate Data
TO SPEED UP THE CERTIFICATION PROCESS AND HELP REDUCE ERRORS, PLEASE SAVE A COPY OF THIS COMPLETED FILE TO
A CD AND INCLUDE THE DISK IN YOUR COMPLETED EAGLE PACKET.
Electronic Eagle Application per 2011 Requirements 2011 ver 1.0
Type in all requested information on this page.
Use MM/DD/YY format to enter all dates!
Scout Information
First Name Middle Name Last Name
OK Justin Other Scout
Zip Code
Street or RFD Address City State
(5 digits only)
OK 90000 N Eagle Street Scottsdale AZ 85260
OK Date of Birth January 15, 1993 Today's Date: November 11, 2011
OK Home Phone (10 digits only) (480) 924-6789 18th Birthday January 15, 2011
OK E-Mail Address joscout@email.com
OK Were you a Cub Scout? Y
OK Were you a Webelos Scout? Y
OK Did you earn the Arrow of Light? Y
Had you completed the fifth grade
N
OK upon joining Boy Scouts?
Unit Information
Unit Type: Unit Address: Unit Address: Zip Code
Registered Unit Number
(Troop, Team, Crew, or Ship only) City State (5 digits only)
OK Crew 9447 Scottsdale AZ 85260
OK Is this an LDS Unit? Y/N Y If Y is selected joining dates will fill in automatically
OK Council Grand Canyon Council #10
OK District Four Peaks
OK PID Number 1000001 Enter PID if known
OK Date joined Boy Scouts January 15, 2004 11 for LDS Scouts
OK Date became a Varsity Scout January 15, 2007 14 for LDS Scouts
OK Date became a Venturer January 15, 2009 16 for LDS Scouts
Unit Leaders Signing Eagle E-mail Address Phone No.
Name Address (Street/PO Box, City, State, Zip)
Application: (Optional) (Numbers only)
OK Unit Leader Will Smith wsmith@yahoo.com P.O. Box 16, Scottsdale, AZ 85260 (480) 700-0006
OK Unit Committee Chair Ron Jones rjones@gmail.com P.O. Box 17, Scottsdale, AZ 85260 (480) 000-0007
OK Unit Advancement Chair Sally Jones sjones@gmail.com P.O. Box 18, Scottsdale, AZ 85260 (480) 000-0007
Scout Rank Information
OK Date Earned First Class Scout Rank November 5, 2004
OK Date Earned Star Rank September 7, 2005 Must be 4 months after First Class Rank
OK Date Earned Life Scout Rank April 23, 2006 Must be 6 months after Star Rank
Date of Eagle Scout Rank Unit Leader Must be after Life Rank and before your 18th
August 29, 2010
OK Conference birthday
References
Reference Name
Five Personal References are Phone No.
References on Eagle
Required: E-mail Address Address: (Street/PO Box, City, State, Zip) (10 digits
Application must match
(Six if you list an Employer) only)
reference letters.
Parents/guardians Tom and Mary Scout thescouts@cox.net (480) 000-0000
OK P.O. Box 10, Scottsdale, AZ 85260
Religious (Must list Parent if Letter
Bishop Sam Jones thebishop@aol.com (480) 000-0001
of Affirmation of Faith is submitted)
OK P.O. Box 10, Scottsdale, AZ 85260
Educational Mary Brown m.brown33@cox.net (480) 000-0002
OK P.O. Box 11, Scottsdale, AZ 85260
Employer (Optional) James Black j.black@gmail.com (480) 000-0003
OK P.O. Box 12, Scottsdale, AZ 85260
Other references (No.1) Judy Williams williams.j@cox.net (480) 000-0005
OK P.O. Box 13, Scottsdale, AZ 85260
Other references (No.2) Tom Smith smithnsons@cox.net (480) 000-0005
OK P.O. Box 14, Scottsdale, AZ 85260
Merit Badge Information
Requirement 2: Merit Badges Earned
OK Enter Date Earned Unit No.
Click on "Select one"
OK 1 CAMPING September 7, 2005 447
OK 2 CITIZENSHIP IN THE COMMUNITY March 15, 2006 447
OK 3 CITIZENSHIP IN THE NATION September 7, 2005 447
OK 4 CITIZENSHIP IN THE WORLD March 15, 2006 447
OK 5 COMMUNICATIONS September 7, 2005 447 For No. 6: Select Emergency Preparedness OR Lifesaving.
OK 6 LIFESAVING March 15, 2006 447 If you earned both badges, choose one to count for Eagle
OK 7 ENVIRONMENTAL SCIENCE September 7, 2005 447 and select the other as elective merit badge No. 19.
OK 8 FIRST AID August 20, 2004 447
OK 9 SWIMMING March 15, 2006 447
OK 10 PERSONAL MANAGEMENT September 21, 2006 447
OK 11 PERSONAL FITNESS March 1, 2005 447 For No. 9: Select Cycling OR Hiking OR Swimming. If
OK 12 FAMILY LIFE September 26, 2007 447 more than one badge was earned, select the oldest to
OK 13 Traffic Safety January 1, 2011 447 count for Eagle and use the other(s) as elective merit
OK 14 Space Exploration March 15, 2006 447 badges No. 20, or 21.
OK 15 Pioneering March 16, 2005 447
OK 16 Archery September 7, 2005 447 The Waterskiing badge was revised and retitled Watersports
OK 17 Orienteering September 7, 2005 447 January 1, 2008.
OK 18 Carpentry July 23, 2010 447 The Auto Mechanics badge was revised and retitled Automotive
OK 19 Wilderness Survival July 20, 2006 447 Maintenance January 1, 2009.
OK 20 Reptile and Amphibian Study September 26, 2007 447
OK 21 Small-Boat Sailing January 7, 2009 447
Candidate Data
Leadership Information
Troop, Team, Crew, or Ship Date From: Date To: (Must be Leadership
Leadership Position(s) Held: (Must be A positions listed on
LIST THE EARLIEST LEADERSHIP (Must be after Life before Scout's 18th Position valid for
OK the Eagle Application under Requirement 4.)
POSITION HELD FIRST Scout date-of-rank) birthday) Unit Type listed?
OK Team Captain January 16, 2007 June 1, 2007 OK
OK Crew Vice President March 1, 2009 September 23, 2009 OK
Eagle Scout Project Information
Eagle Scout Rank Leadership Service Project Information:
(The project MAY NOT benefit an individual, a business, Boy Scouts, or consist totally of routine labor.)
(The project MAY benefit any religious institution, any school, or the community)
OK Benefiting Organization Pinnacle Peak Park (City of Scottsdale)
OK Project name: (brief description of project) Trail repair and enhancement
OK Applicant's Hours 15.5
OK Total Project Service Hours 154.75
OK Date Project was Started March 19, 2010
OK Date Project was Completed May 22, 2010
ERROR CHECKS
READY TO PRINT the 2 pages of the EAGLE 61 61 0 Optional 61 OK
APPLICATION
Signatures on the Eagle Application
OK Did you sign the Eagle Application Y
OK Date of Eagle Candidate Signature August 29, 2010
OK Did the unit leader sign Y August 29, 2010
OK Date of Unit Leader Approval August 29, 2010
OK Did the unit committee chair sign Y
OK Date of Unit Committee Chair August 29, 2010
Project Workbook
OK Eagle Scout Rank Leadership Service Project Workbook included? Y
OK Do you have project approval signatures? Y
OK Do you have project completion signatures? Y
OK Project narrative detailing leadership given during project included? Y
OK Written statement of Ambitions and Life Purpose included? Y
OK Recognitions and positions of honor outside Scouting included? Y
OK All letters of recommendation included? Y
District Certification
OK Date Packet Submitted for District or Council Certification January 3, 2011
OK Date of Council Certification January 5, 2011
OK Date of Scheduled Eagle Board of Review January 13, 2011
READY TO PRINT the rest of the sheets in
77 77 0 Optional 77 OK
this file
TO SPEED UP THE CERTIFICATION PROCESS AND HELP REDUCE ERRORS, PLEASE SAVE A COPY OF THIS COMPLETED FILE TO
A CD AND INCLUDE THE DISK IN YOUR COMPLETED EAGLE PACKET.
Merit Badges
Merit Badge Check FOR INFORMATION ONLY!
Candidate's Name: Justin Other Scout
Must be after Life
Merit Badge Data: Must be after date-of rank and at Name, Date & Counts Counts Counts Duplication
Date Earned
Required Badges joining Scouts least one day beore Unit for Star for Life for Eagle Check
18th Birthday
1 Camping 9/7/2005 OK OK OK 1 1 1
2 Citizenship in the Community 3/15/2006 OK OK OK 1 1
3 Citizenship in the Nation 9/7/2005 OK OK OK 1 1 1
4 Citizenship in the World 3/15/2006 OK OK OK 1 1
5 Communications 9/7/2005 OK OK OK 1 1 1
6 LIFESAVING 3/15/2006 OK OK OK 1 1
7 Environmental Science 9/7/2005 OK OK OK 1 1 1
8 First Aid 8/20/2004 OK OK OK 1 1 1
9 SWIMMING 3/15/2006 OK OK OK 1 1
10 Personal Management 9/21/2006 OK OK OK 1
11 Personal Fitness 3/1/2005 OK OK OK 1 1 1
12 Family Life 9/26/2007 OK OK OK 1
Total Current Required Merit Badges Earned 6 10 12
Plus second #6 merit badge for Star or Life if earned. 0 0
Plus second and/or third #9 merit badge for Star or Life if earned. 0 0
Eligible Required Merit Badges Earned 6 10 12
Required Badges Needed 4 7 12
Must be after Must be before SM Name, Date & Counts Counts Counts Duplication
Elective Badges Date Earned
joining Scouts Conference Unit for Star for Life for Eagle Check
13 Traffic Safety 1/1/2011 OK OK OK 1
14 Space Exploration 3/15/2006 OK OK OK 1 1
15 Pioneering 3/16/2005 OK OK OK 1 1 1
16 Archery 9/7/2005 OK OK OK 1 1 1
17 Orienteering 9/7/2005 OK OK OK 1 1 1
18 Carpentry 7/23/2010 OK OK OK 1
19 Wilderness Survival 7/20/2006 OK OK OK 1
20 Reptile and Amphibian Study 9/26/2007 OK OK OK 1
21 Small-Boat Sailing 1/7/2009 OK OK OK 1
Total Elective Merit Badges Earned 3 4 9
Extra Required Merit badges Earned 2 3 0
Eligible Elective Merit Badges Earned 5 7 9
Elective Badges Needed 2 4 9
Total Required and Elective Merit Badges Earned 9 14 21
Total Merit Badges Needed 6 11 21
Date Emergency Preparedness earned Emergency Prep. Earned on or after First Aid
Was Emergency Prep before first aid OK date.
Date Lifesaving earned 3/15/2006
Lifesaving/swim pre-req cut off date 1/1/01 If Lifesaving was earned before 1/1/01,
Lifesaving earned before 1/1/01 NO Swimming was a prerequisite, and must have
Date Swimming earned 3/15/2006 been earned on or before Lifesaving date.
Was the swim pre-req met OK
Date Checks
FOR INFORMATION ONLY!
Candidate's Name: Justin Other Scout
Join Age or
18th
Dates to Check Date or Pre Time in Items Checked
B'Day
Req Rank
1/15/1993 OK Board of Review less than 18 1/2 years after Birth Date,
Birth Date
OR Current Date less than 18 1/2 years after Birth Date.
Joined Scouts with
1/15/2004 YES OK OK Arrow of Light, at least 10, less than 18 years old
Arrow of Light
Joined Scouts at Eleven Years Old
At least 11, less than 18 years old
(All LDS Units)
Joined Scouts after Completing 5th
Completed 5th Grade, less than 18 years old
Grade
1st Class Rank 11/5/2004 OK OK After Joining
Star Rank 9/7/2005 OK OK OK At least 4 months as First Class Scout
Life Rank 4/23/2006 OK OK OK At least 6 months as Star Scout
The conference must occur after the Life Scout date-of-rank
Eagle Unit Leader Conference 8/29/2010 OK OK
and prior to the Scout's 18th Birthday.
All Eagle Scout requirements must be completed before the
18th Birthday 1/15/2011 OK OK
18th Birthday.
Packet must be submitted promptly after all requirements for
Packet to council 1/3/2011 OK OK
Eagle Scout Rank are complete.
Varsity Scout 1/15/2007 OK OK Must be 14 Yrs old before becoming Varsity Scout
Venturer (non-LDS Unit) First Class and 14 Yrs old before becoming Venturer
Venturer (LDS Unit) 1/15/2009 OK OK OK First Class and 16 Yrs old before becoming Venturer
Project Started 3/19/2010 OK Project started after Life Board of Review
Project Completed 5/22/2010 OK OK Project completed before 18th birthday
Days in Unit Type Leadership Position Validity Check
Leadership Position(s) Held
Position
Captain 136 Team
Vice President 206 Crew
Total Days in Leadership
342 It is BSA practice to assume all months have 30 days for calculating rank advancement
Position Must Be 180 Minimum
and leadership requirements.
Days Short of Requirement 0
Date Joined Scouts 1/15/2004
90 days after joining 4/14/2004
Six Months after 18th Birthday 7/15/2011
Three Months after 18th Birthday 4/15/2011
Four Months after First Class 3/5/2005
Six Months after Star 3/7/2006
Six Months after Life 10/23/2006
10 years old 1/15/2003
11th Birthday 1/15/2004
14th Birthday 1/15/2007
16th Birthday 1/15/2009
Grand Canyon Council EAGLE AWARD APPLICATION 2969 East Greenfield Road
Boy Scouts of America CERTIFICATION CHECK SHEET Phoenix, AZ 85016
11/11/2011 (602) 955-7747
Your Eagle Scout Application is in error for the following reason(s). Correct all errors prior to your District Board of Review.
OK/ERROR 1 REGISTRATION AND SIGNATURES - FOR COUNCIL OR DISTRICT USE ONLY 2011 ver 1.0
Automated For District/Concil use - Select "Manual" in Cell A3 for manual review of a packet
OK OK a. Candidate not registered in unit indicated but is registered in Unit # Correct application or transfer Scout.
Scout, Justin Other
OK OK b. Candidate not registered in any unit.
OK OK c. Scout signature missing
OK OK d. Unit leader signature missing
OK OK e. Name, address, and/or phone missing for the Unit Leader
NAME
OK OK f. Committee chairperson signature missing.
OK OK g. Name, address, and/or phone missing for the Unit Committee Chair
OK OK h. Unit leader not registered. Need signature of or register leader who signed.
OK OK i. Committee Chairperson not registered. Need signature of or register leader who signed.
2 DATES & MISC. - You must list month day and year for all dates. Computer dates must be filled in completely. Example: MM/DD/YY
OK OK a. Scouts name is incomplete. (First, middle & last name)
OK OK c. Date of Birth is Missing
OK OK d. Scout's address is incomplete. (Street, City, State & Zip)
OK OK e. Scout's phone number is missing.
OK OK f. Date became a Boy Scout
OK OK g. Date became a Varsity Scout
Crew 9447
OK OK h. Date became a Venturer
OK OK i. Some information on the Eagle Application is incomplete or confusing.
UNIT
OK OK j. Eagle application form is not acceptable for the following reason:
OK OK k. Must have 4 months (120 days minimum) between First Class and Star Scout Boards of Review. Short 0 days.
OK OK l. Must have 6 months (180 days minimum) between Star and Life Scout Boards of Review. Short 0 days.
OK OK m. Must have served 6 months (180 days minimum) as a Life Scout. Short 0 days.
OK OK n. Need unit number or date for merit badge numbers
OK OK o. Missing date of project start.
OK OK p. Missing date of project completion.
OK OK q. Missing date of Scoumaster Conference with unit leader.
OK OK r. Missing or incomplete dates on signatures.
Four Peaks
DISTRICT
OK OK s. Application certification date is more than 90 days after 18th birthday. Preapproval is required.
OK OK t. Application certification date is more than 180 days days after 18th birthday. See Eagle Boards of Review section below.
3 MERIT BADGES
OK OK a. You must cross off merit badges not earned for #6 and #9.
OK OK b. Unit number is missing for the following merit badge numbers
OK OK c. You duplicated one or more Merit Badge titles. Click on the Merit Badges tab below for details then make correction.
OK OK d. Prerequisite First Aid Merit Badge must be earned on or before date Emergency Preparedness was earned.
OK OK e. The Historical Merit Badges Carpentry, Pathfinding, Signaling, and Tracking must have been earned by December 31, 2010.
OK OK f. One or more merit badges are dated before the Scout's life date-of-rank or ON OR AFTER his 18th birthday.
OK OK g. The Personal Management, Personal Fitness, and Family Life badges cannot be earned less than 90 days after joining Scouts.
OK OK h. At least FOUR required merit badges must be earned prior to Star date. Short 0
OK OK i. At least SIX merit badges must be earned prior to Star date. Short 0
OK OK j. At least SEVEN required merit badges must be earned prior to Life date. Short 0
CERTIFICATION DATE
OK OK k. At least ELEVEN merit badges must be earned prior to Life date. Short 0
January 5, 2011
OK OK l. At least TWELVE required merit badges must be earned prior to Eagle date. Short 0
OK OK m. At least TWENTY-ONE merit badges must be earned prior to Eagle date. Short 0
4 POSITIONS OF RESPONSIBILITY
OK OK a. First Leadership position "Date From" is not after Life Board of Review.
OK OK b. First Leadership date not valid for unit
OK OK c. First leadership position not valid for the type of unit
OK OK d. Second Leadership position "Date From" is not after Life Board of Review.
OK OK e. Second Leadership date not valid for unit
OK OK f. Second Leadership position not valid for the type of unit
OK OK g. Leadership dates total less than six months. Short 0 days.
5 SERVICE PROJECT
OK OK a. Need completion signature from organization receiving project.
OK OK b. Project not completed before Scout's 18th Birthday
OK OK c. Project not started and completed between Life Scout date-of-rank and the Scout's 18th birthday.
OK OK d. Project benefiting organization, description and/or hours missing
OK OK e. Project narrative detailing leadership given during project is missing.
OK OK f. Current Eagle Scout Rank Leadership Service Project Workbook is missing.
OK OK g. All project workbook information included
h. Missing document for requirement number 6:
OK OK (A) written statement of Ambitions and Life Purpose.
PHONE NUMBER
(480) 924-6789
OK OK (B) Recognitions and positions of honor outside Scouting
6 REFERENCES
OK OK a. Missing the following reference(s).
OK OK b. All names, address and phone number of the references entered 60
OK OK c. Names of references listed on the application and on the references letters do not match. 60
Obtain references from those listed or change names on application. 60
Eagle Boards of Review: Scouts and Venturers who have completed all requirements prior to their 18th birthday, may be reviewed within three
months after that date with no explanation. Boards of review conducted between three and six months after the candidate’s 18th birthday must
be preapproved by the local council. A statement by an adult explaining the reason for the delay must be attached to the Eagle Scout Rank
Application when it is submitted to the Eagle Scout Service. (In Grand Canyon Council the district advancement committee chairperson will
provide the necessary preapproval by cosigning the required statement). The Boy Scout Division at the National Office must be contacted for
procedures to follow if a board of review is to be conducted more than six months after a candidate's 18th birthday.
Comment: Good project and report - no errors
E-mail
Candidate Name: Scout, Justin Other joscout@email.com Unit: Crew 9447
Address: PID Number 1000001
Certified
Address: 90000 N Eagle Street Scottsdale AZ 85260 Home Phone (480) 924-6789 Birth Date: 1/15/1993
Project name: Trail repair and enhancement
(a brief project description):
Pinnacle Peak Park (City of
Certification submission date: 1/3/11 Total Project Service Hours: 154.75 Project recipient:
Scottsdale)
Eagle Packet Certified by: Larry Morris Date: January 5, 2011 District: Four Peaks
Eagle Board of Review Date: 1/13/2011 Date Recorded: Date to National:
Eagle Award received by: _________________________________________________________ Date: ___________________________
FOR COUNCIL USE ONLY
EAGLE SCOUT RANK APPLICATION COUNCIL NO. TYPE OF UNIT
TO THE EAGLE SCOUT RANK APPLICANT. This application is to be completed after you 10 Crew
C, REGION
N, S, NATIONAL NO.
have completed all requirements for the Eagle Scout rank. Print in ink or type all
W 9447
information. List the month, day, and year for all dates. When using computer date blocks o
list the date: July 8, 1970 as 07 (for July) 08 (for day) 70 (for year). When you have completed
this application, sign it and submit it to your unit leader. Justin Other Scout
PID NO. (REQUIRED)
1000001
LIST YOUR FULL LEGAL NAME (UP TO 30 CHARACTERS ONLY).
Justin Other Scout
Month Day Year
90000 N Eagle Street Date joined a Boy Scout Troop 01/15/04
Street or RFD Address Date became a Varsity Scout 01/15/07
Scottsdale AZ 85260 Date became a Venturer 01/15/09
City, State, Zip Date of First Class Scout board of review 11/05/04
(480) 924-6789 Date of Star Scout board of review 09/07/05
Phone (Including area code) Were You a Cub Scout? X Yes No
Crew 9447 Were you a Webelos Scout? X Yes No
Troop, Team, Crew, or Ship Local No. Did you earn the Arrow of Light Award? X Yes No
Scottsdale AZ 85260 Had you completed the fifth grade upon joining? Yes X No
City, State, Zip
AGE REQUIREMENT ELIGIBILITY. Merit Badges, badges of rank, and Eagle Palms may be earned by a registered Boy Scout, Varsity Scout, or Venturer. He may earn these awards
until his 18th birthday. Any Venturer who achieved the First Class Rank as a Boy Scout in a troop or Varsity Scout in a team may continue to working for the Star, Life, and Eagle Scout
ranks and Eagle Palms while registered as a Venturer up to his 18th birthday. Scouts and Venturers who have completed all requirements prior to their 18th birthday may be
reviewed within three months after that date with no explanation. Boards of review conducted between three and six months after the candidate's 18th birthday must be preapproved
by the local council. A statement by an adult explaining the reason for the delay must be attached to the Eagle Scout Rank Application when it is submitted to the local council service
center. The Program Impact Department at the national office must be contacted for procedures to follow if a board of review is to be conducted more than six months after a
candidate's 18th birthday.
A Scout or Venturer with a disability may work toward rank advancement after he is 18 years of age. See
Date of Birth
01/15/93
Advancement Committee Policies and Procedures for details.
Month Day Year
REQUIREMENT 1. Be active in your troop, team, crew, or ship for a period of at least six months after you have Date of Life Scout
board of review
04/23/06
achieved the rank of Life Scout.
Month Day Year
REQUIREMENT 2. Demonstrate that you live by the principles of the Scout Oath and Law in your daily life. List the names of individuals who know you personally and would
be willing to provide a recommendation on your behalf.
Name Address Telephone E-mail
Parents/guardians Tom and Mary Scout P.O. Box 10, Scottsdale, AZ 85260 (480) 000-0000 thescouts@cox.net
Religious Bishop Sam Jones P.O. Box 10, Scottsdale, AZ 85260 (480) 000-0001 thebishop@aol.com
Educational Mary Brown P.O. Box 11, Scottsdale, AZ 85260 (480) 000-0002 m.brown33@cox.net
Employer (if any) James Black P.O. Box 12, Scottsdale, AZ 85260 (480) 000-0003 j.black@gmail.com
Two other references Judy Williams P.O. Box 13, Scottsdale, AZ 85260 (480) 000-0005 williams.j@cox.net
Tom Smith P.O. Box 14, Scottsdale, AZ 85260 (480) 000-0005 smithnsons@cox.net
REQUIREMENT 3. Earn a total of 21 merit badges (required merit badges are listed). List the month, day, and year the badge was earned.
DATE UNIT DATE UNIT DATE UNIT NO.
MERIT BADGE EARNED NO. MERIT BADGE EARNED NO. MERIT BADGE EARNED
1 CAMPING 09/07/05 447 8 FIRST AID 08/20/04 447 15 Pioneering 03/16/05 447
2 CITIZENSHIP IN 03/15/06 447 *† 9 CYCLING OR HIKING 03/15/06 447 16 Archery 09/07/05 447
THE COMMUNITY OR SWIMMING
3 CITIZENSHIP IN 09/07/05 447 10 PERSONAL 09/21/06 447 17 Orienteering 09/07/05 447
THE NATION MANAGEMENT
4 CITIZENSHIP IN 03/15/06 447 †11 PERSONAL FITNESS 03/01/05 447 18 Carpentry 07/23/10 447
THE WORLD
5 COMMUNICATIONS 09/07/05 447 12 FAMILY LIFE 09/26/07 447 19 Wilderness Survival 07/20/06 447
6 EMERGENCY PREPARED- 03/15/06 447 13 Traffic Safety 01/01/11 447 20 Reptile and Amphibian Study 09/26/07 447
NESS OR LIFESAVING
7 ENVIRONMENTAL 09/07/05 447 14 Space Exploration 03/15/06 447 21 Small-Boat Sailing 01/07/09 447
SCIENCE
*Cross out badges not earned. If a crossed-out badge was earned, it may be reentered in 13 through 21.
Four of these required merit badges were earned for the Star Scout rank and three more were earned for the Life Scout rank.
BOY SCOUTS OF AMERICA
REQUIREMENT 4. While a Life Scout, serve actively for a period of six months in one or Venturing crew/ship. President, vice president, secretary, treasurer, den
more of the following positions of responsibility. List only those positions served after Life chief, quartermaster, historian, guide, boatswain, boatswain's mate, yeoman,
Board of Review date. purser, storekeeper, Webmaster or Leave No Trace trainer
Boy Scout Troop. Patrol leader, Venture patrol leader, assistant senior patrol leader,
senior patrol leader, troop guide, Order of the Arrow troop representative, den chief, scribe, Lone Scout. Leadership responsibility in his
librarian, historian, quartermaster, junior assistant Scoutmaster, chaplain aide, instructor, school, religious organization, club, or elsewhere in his community
Webmaster or Leave No Trace trainer
Varsity Scout Team. Captain, cocaptain, program
manager, squad leader, team secretary, Order of the Arrow team representative, librarian,
historian, quartermaster, chaplain aide, instructor, den chief, Webmaster or Leave No Trace
trainer
Date of Life Scout
board of review 0 4 2 3 0 6
Month Day Year
Position Captain FROM 0 1 1 6 0 7 TO 0 6 0 1 0 7
Month Day Year Month Day Year
Position Vice President FROM 0 3 0 1 0 9 TO 0 9 2 3 0 9
Month Day Year Month Day Year
REQUIREMENT 5. While a Life Scout, plan, develop, and give leadership to others in a service project helpful to any religious organization, any school, or your community. The project plan
must be approved by your unit leader and unit committee, by the council or district, and by the organization benefiting from the effort before you start.
You must use the Eagle Scout Leadership Service Project Workbook, No. 512-927, in meeting this requirement.
Project Name: Trail repair and enhancement Date of final signature 0 5 2 2 1 0
Month Day Year
Grand total of hours: 154.75 (from page 10 of Eagle Scout Leadership Project Workbook- for statistical purposes only)
REQUIREMENT 6. Take part in a unit leader conference. Attach to this application a statement of your ambitions and life purpose and a listing of positions held in your religious institution, school,
camp, community, or other organizations during which you showed demonstrated leadership skills. Include honors and awards received during this service.
Date conference was held 0 8 2 9 1 0
Month Day Year
CERTIFICATION BY APPLICANT. On my honor as a Scout/Venturer, all statements on this application are true and correct. All requirements were completed prior to my 18th
birthday
Signature of applicant Telephone (480) 924-6789 DATE 0 8 2 9 1 0
Justin Other Scout Month Day Year
UNIT APPROVAL (personal signatures required)
Signature of unit leader Telephone (480) 700-0006 DATE 0 8 2 9 1 0
Month Day Year
Will Smith
Scoutmaster, Coach, or Advisor
Signature of unit committee chair Telephone (480) 000-0007 DATE 0 8 2 9 1 0
Ron Jones Month Day Year
BSA LOCAL COUNCIL CERTIFICATION. According to to the records of this council, the applicant is a registered member of this unit and this application is approved as accurate.
Signed Position DATE 0 1 0 5 1 1
Month Day Year
Successsfully complete an Eagle Scout Board of Review. The applicant appeared before the Eagle Scout board of review on this date, and this application was approved.
Review Date This date will be used on the Eagle Scout credentials.
Month Day Year
Signature of Eagle Scout board of review chairman Signature of council/district board representative(if applicable)
I certify that all procedures, as outlined in Advancement Committee Policies and Procedures, have been followed. I approve this application.
Scout Executive DATE
Month Day Year
Presentation of the rank may not be made until the Eagle Scout credentials are received by EAGLE SCOUT SERVICE VALIDATION
the BSA local council.
NATIONAL EAGLE SCOUT ASSOCIATION. The National Eagle Scout
Association is a fellowship of men who have achieved Eagle Scout Rank.
Membership embraces the top achievers of the Boy Scouts of America.
Benefits include a subscription to Eagletter . The journal keeps NESA members
informed on Scouting in general and Eagle Scouting in particular.
Applications are available at your local council service center.
Regular five-year memberships are $25. Life memberships are $180.
Please use the most current application found at www.scouting.org/scoutsource/media/forms.aspx.
512-728 GCC
2010 Printing
DISTRICT ADVANCEMENT RECORD
Grand Canyon Council #10 Four Peaks District BOY SCOUTS OF AMERICA
BOARD OF REVIEW DATE: 1/13/11 TIME: 6:30 P.M.. ROOM NUMBER: __________
CANDIDATE'S NAME: Justin Other Scout CANDIDATE'S PHONE: (480) 924-6789
UNIT TYPE AND NUMBER: Crew 9447 CANDIDATE'S AGE: 18.8
E-MAIL ADDRESS: (not required) joscout@email.com CANDIDATE'S DOB: 01/15/93
UNIT LEADER'S NAME: (X) Will Smith LEADER'S PHONE: (X) (480) 700-0006
DISTRICT REVIEWER #1 (XX) PHONE: (XX)
DISTRICT REVIEWER #2 (XX) PHONE: (XX)
DISTRICT REVIEWER #3 (XX) PHONE: (XX)
BOARD MEMBER #1 (X) PHONE: (X)
BOARD MEMBER #2 (X) PHONE: (X)
BOARD MEMBER #3 (X) PHONE: (X)
DESCRIPTION OF EAGLE PROJECT:
Trail repair and enhancement WILL UNIT LEADER INTRODUCE CANDIDATE? (X)
YES _____ NO _____
DATE OF EAGLE PROJECT: 5/22/10 EAGLE PROJECT SERVICE HOURS:
SERVICE PROJECT RECIPIENT: Pinnacle Peak Park (City of Scottsdale) TOTAL HOURS: 154.75
CANDIDATE'S HOURS: 15.5
CANDIDATE'S FULL MAILING ADDRESS:
STREET / PO BOX / APARTMENT # 90000 N Eagle Street
CITY / STATE / ZIP: Scottsdale AZ 85260
THIS SECTION FOR DISTRICT USE ONLY:
IS BOARD BEING HELD AFTER 18TH BIRTHDAY? (XX) YES _____ NO _____ SIGNATURE OF BOARD CHAIRPERSON:(XX)
IS THIS AN APPEAL? (XX) YES _____ NO _____
RECOMMENDATION OF BOARD OF REVIEW: (XX) PASS _____ FAIL _____ IS AN APPEAL EXPECTED? (XX) YES _____ NO _____
COMMENTS IF RECOMMENDATION IS FAIL: (XX)
EAGLE CANDIDATE: COMPLETE ALL (X) ITEMS BEFORE COMING TO THE BOARD OF REVIEW
REVISED MARCH 2010 BOARD OF REVIEW CHAIR: COMPLETE ALL (XX) ITEMS AT THE BOARD OF REVIEW
