INDIVIDUAL SCOUT RECORD PERSONAL DATA
Name _______________________________________________________________________ Address _____________________________________________________________________ City_______________________ State, zip code ____________________________________ Phone________________________ Date of birth __________________________________ Church or synagogue_________________________________________________________ School_________________________________________________________________________ ____________________________________________________________________________________________ Parent’s name _______________________________________________________________ Business address _____________________________________________________________ City_______________________ State, zip code ____________________________________ Business phone__________________________ Occupation _________________________ __________________________ __________________________ __________________________ NO._______________
TROOP/TEAM
PATROL
MEMBERSHIP
Cub Scout—from________ to_________ Rank _________ Webelos Scout—from_____________ to ______________ Pack No.__________ City__________ State ____________ Became Boy Scout (registered) . . . . . Transfer in . . . . . . . . . . . . . . . . . . . . . . Transfer out . . . . . . . . . . . . . . . . . . . . ______________
Date Date Date
Became Varsity Scout or Venturer . . .
______________
Date
ORDER OF THE ARROW
Election . . . . . . . . . . . . . . . . . . . . . . . . ______________
Date Date
Ordeal . . . . . . . . . . . . . . . . . . . . . . . . . Brotherhood . . . . . . . . . . . . . . . . . . . . Vigil Honor . . . . . . . . . . . . . . . . . . . . .
H = PRESENT ON TROOP HIKE C = PRESENT AT OVERNIGHT CAMP C3 = (Numeral indicates number of days and nights in camp)
______________
____________________ Date ____________________ Date
______________ ______________
ATTENDANCE AND DUES
YEAR ATTENDANCE DATE
T = PRESENT AT TROOP MEETING S = PRESENT AT SERVICE PROJECT A = PRESENT AT TROOP, DISTRICT, OR COUNCIL ACTIVITY
10¢, 15¢, 25¢, 50¢, $1 = AMOUNT PAID ON DATE SHOWN ✓ = DUES PAID AHEAD OR BACK
YEAR DUES DATE ATTENDANCE DUES
YEAR ATTENDANCE DATE DUES
d d d d d d d d d d d d
d d d d d d d d d d d d
d d d d d d d d d d d d
JAN. DATE FEB. DATE MAR. DATE APR. DATE MAY DATE JUNE DATE JULY DATE AUG. DATE SEPT. DATE OCT. DATE NOV. DATE DEC.
JAN. DATE FEB. DATE MAR. DATE APR. DATE MAY DATE JUNE DATE JULY DATE AUG. DATE SEPT. DATE OCT. DATE NOV. DATE DEC.
JAN. DATE FEB. DATE MAR. DATE APR. DATE MAY DATE JUNE DATE JULY DATE AUG. DATE SEPT. DATE OCT. DATE NOV. DATE DEC.
Scout’s last name
TROOP POSITIONS OF RESPONSIBILITY
From (Date) To (Date)
ADVANCEMENT REQUIREMENTS
Enter date earned for each merit badge, rank, and individual requirement. Indicate specific skills and merit badges earned for each rank.
9b. 9c. 9d. 10. 11. 12.
BSA swimmer test Water survival skills Line rescue Scout spirit Scoutmaster conference Board of review
____ ____ ____ ____ ____ ____
Den chief . . . . . . . . . . . . . . . . . . . . ____________ ____________
Librarian . . . . . . . . . . . . . . . . . . . . Quartermaster . . . . . . . . . . . . . . . Scribe . . . . . . . . . . . . . . . . . . . . . . . Historian . . . . . . . . . . . . . . . . . . . . Instructor . . . . . . . . . . . . . . . . . . . Varsity program manager . . . . . . Chaplain aide . . . . . . . . . . . . . . . . Varsity team captain . . . . . . . . . . Varsity team co-captain . . . . . . . . Varsity team secretary . . . . . . . . . Patrol leader . . . . . . . . . . . . . . . . . Squad leader . . . . . . . . . . . . . . . . . Assistant senior patrol leader . . . Senior patrol leader . . . . . . . . . . . Troop guide . . . . . . . . . . . . . . . . . . Junior assistant Scoutmaster . . . . ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________
STAR RANK
Date 1. Participation ____ 2. Scout spirit ____ 3. _______ merit badge* ____ 4. _______ merit badge* ____ 5. _______ merit badge* ____ 6. _______ merit badge* ____ 7. _______ merit badge ____ 8. _______ merit badge ____ 9. Service project ____ 10. Position of responsibility ____ 11. Scoutmaster conference ____ 12. Board of review ____ *Total of 6 merit badges, including any 4 from required list for Eagle.
BOY SCOUT
Date 1. Joining requirements ____ 2. Scoutmaster conference ____
TENDERFOOT RANK
1. 2. 3. 4a. 4b. 5. 6. 7. 8. 9. 10a. 10b. 11. 12a. 12b. 13. 14. Preparing to camp Overnight camp Preparing a meal Whipping and fusing rope Tying hitches Safe hiking rules Care of the flag Scouting principles Patrol knowledge Buddy system Physical test Physical improvement Poisonous plants Heimlich maneuver First aid Scoutmaster conference Board of review Date ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ Date ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ Date ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____
LIFE RANK
Date 1. Participation ____ 2. Scout spirit ____ 3. _______ merit badge* ____ 4. _______ merit badge* ____ 5. _______ merit badge* ____ 6. _______ merit badge ____ 7. _______ merit badge ____ 8. Service project ____ 9. Position of responsibility ____ 10. Scoutmaster conference ____ 11. Board of review ____ *Total of 11 merit badges, including any 3 more from required list for Eagle.
Note: Each of the positions of responsibility listed above can help fulfill requirements for the Eagle Scout Award.
MERIT BADGE LIST
1. Camping 2. Citizenship in the Community 3. Citizenship in the Nation 4. Citizenship in the World 5. Communications 39. Cycling 6. Emergency Preparedness 7. Environmental Science 129. Family Life 8. First Aid 61. Hiking 9. Lifesaving 10. Personal Fitness 11. Personal Management 14. Swimming 15. American Business 17. American Cultures 16. American Heritage 121. American Labor 18. Animal Science 132. Archaeology 19. Archery 20. Architecture 21. Art 22. Astronomy 23. Athletics 24. Atomic Energy 127. Auto Mechanics 25. Aviation 26. Backpacking 27. Basketry 29. Bird Study 32. Bugling 33. Canoeing 34. Chemistry 126. Cinematography 133. Climbing 35. Coin Collecting 128. Collections 36. 38. 131. 40. 60. 41. 42. 43. 44. 45. 46. 134. 48. 49. 50. 51. 52. 54. 55. 56. 58. 59. 122. 62. 63. 64. 65. 66. 67. 68. 69. 71. 130. 74. 75. 76. 77. 78. 79. 80. 81. 82. 83. Computers Cooking Crime Prevention Dentistry Disabilities Awareness Dog Care Drafting Electricity Electronics Energy Engineering Entrepreneurship Farm Mechanics Fingerprinting Fire Safety Fish and Wildlife Management Fishing Forestry Gardening Genealogy Geology Golf Graphic Arts Home Repairs Horsemanship Indian Lore Insect Study Journalism Landscape Architecture Law Leatherwork Mammal Study Medicine Metalwork Model Design and Building Motorboating Music Nature Oceanography Orienteering Painting Pets Photography 84. 85. 86. 87. 89. 90. 91. 93. 94. 95. 96. 123. 98. 12. 99. 100. 101. 124. 103. 105. 104. 106. 107. 13. 108. 109. 110. 111. 112. 113. 114. 115. 116. 125. 117. 118. 119. Pioneering Plant Science Plumbing Pottery Public Health Public Speaking Pulp and Paper Radio Railroading Reading Reptile and Amphibian Study Rifle Shooting Rowing Safety Salesmanship Scholarship Sculpture Shotgun Shooting Skating Small-Boat Sailing Snow Sports Soil and Water Conservation Space Exploration Sports Stamp Collecting Surveying Textile Theater Traffic Safety Truck Transportation Veterinary Medicine Waterskiing Weather Whitewater Wilderness Survival Wood Carving Woodwork
SECOND CLASS RANK
1a. 1b. 2a. 2b. 2c. 2d. 2e. 2f. 2g. 3. 4. 5. 6a. 6b. 6c. 7a. 7b. 7c. 8. 9. 10. 11. Map and compass use Map and compass hike Troop/patrol activities Tent pitching Wood tools Cooking fire Lightweight stoves Lighting a fire and stove Preparing a meal Care of the flag Service project Animal identification “Hurry” cases First-aid kit First aid Safe swimming Swimming skills Water rescue methods Health programs Scout spirit Scoutmaster conference Board of review
EAGLE SCOUT AWARD
Date 1. Participation ____ 2. Scout spirit ____ 3. _______ merit badge* ____ 4. _______ merit badge* ____ 5. _______ merit badge* ____ 6. _______ merit badge* ____ 7. _______ merit badge* ____ 8. _______ merit badge ____ 9. _______ merit badge ____ 10. _______ merit badge ____ 11. _______ merit badge ____ 12. _______ merit badge ____ 13. Position of responsibility ____ 14. Service project ____ 15. Scoutmaster conference ____ 16. Board of review ____ *Total of 21 merit badges, including 12 (at least one in each category) from the required list for Eagle. See Boy Scout Requirements for categories.
FIRST CLASS RANK
1. 2. 3. 4a. 4b. 4c. 4d. 4e. 5. 6. 7a. 7b. 7c. 8a. 8b. 8c. 8d. 9a. Finding your way Orienteering Troop/patrol activities Planning a menu Purchasing food Cooking gear Safe handling of food Camp cooking Citizenship Plant identification Appropriate use of lashings Hitches and lashings Camp gadget Bowline knot Bandages Transporting a victim CPR Safe trip afloat
BRONZE PALM
________________________________ Date
GOLD PALM
________________________________ Date
SILVER PALM
________________________________ Date
#34518B
Merit badges on required list for Eagle are in boldface. 34518B 2000 Boy Scouts of America Revised 1999
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