Merit Badge Counselor Information Form

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Boy Scouts of America
MERIT BADGE COUNSELOR INFORMATION
Troop ________ Email _______________________
(Please type or print)
Name ______________________________________________Age _____ Business Phone (____) ________________
Address _______________________________________________________ Home Phone (____) _______________
City ____________________________________________________________ State ______ Zip Code ____________
To qualify as a merit badge counselor, you must:
As a merit badge counselor, I agree to:
Be at least 18 years old
Follow the requirements of the merit badge, making no
deletions or additions, ensuring that the advancement
Be proficient in the merit badge subject by vocation or
standards are fair and uniform for all scouts.
avocation.
Have a Scout and his buddy present at all instructional
Be able to work with Scout-age boys
sessions.
Be registered with the Boy Scouts of America
Renew my registration annually if I plan to continue as a
merit badge counselor.
Is this subject in line with your
Do you follow this subject as a
If not, do you have any special
job, business, or profession? If
hobby, having more than a
training, or other qualifications
yes, give brief information on
"working knowledge" of the
for this subject? If yes, give
the reverse side.
requirements? If yes, give brief
brief information on the reverse
information on the reverse side.
side.
List merit badge subjects here
1.
2.
3.
4.
5.
6.
7.
There is no fee for becoming a merit badge counselor. You need only to submit this form and an BSA Adult Application Form
upon initial registration. Confirmation of your continued interest in serving as a merit badge counselor should resubmitted on an
annual basis.
CHECK ONE:
I wish to work only with _____________
(Unit Number)
I wish to work with all units.
Signature____________________________________________________________ Date________________
Note: The BSA Adult Application must be attached.
Council approval by ___________________________________________________ Date ________________

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