FRENCH CREEK COUNCIL – MERIT BADGE COUNSELOR INFORMATION (REV. 12/12/11)
(Please type or print)
Name ___________________________________________________ Date of Birth ______/_____/_____ Business phone (_____) _________________
Address _____________________________________________________________________________ Home phone (______) ___________________
City _________________________________________State ____________ Zip code ______________ Email __________________________________
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
•
•
Be proficient in the merit badge subject by vocation,
deletions or additions, ensuring that the advancement
•
avocation, or special training/
standards are fair and uniform for all Scouts.
Be able to work with Scout age boys.
Have a Scout and his buddy present at all instructional
•
•
Be registered with the Boy Scouts of America
sessions
•
Renew my registration annually if I plan to continue as a
•
merit badge counselor.
Vocation – Is this subject
Avocation – Do you
Special Training – If
in line with your job,
follow this subject as a
not, do you have any
business, or profession? If
hobby, having more than a
special training or other
yes, give brief information
“working knowledge” of
qualifications for this
List merit badge subject here.
on the reverse side.
the requirements? If yes,
subject? If yes, give
give brief information on
brief information in the
the reverse side.
reverse side.
1
2
3
4
5
6
7
8
Registered member of the Boy Scouts of America: YES ____ NO ____
Recommended by: _________________________________________
Home phone: (_____) ________________________
All applications MUST be accompanied by an Adult Application and enter “42” under the Position Code and copy of BSA Youth
Attach NRA
Protection Certificate . This application must be submitted 90 days prior to beginning to counsel a Merit Badge.
certificate if required for your merit badge.
Mail to:
Applicants Signature _________________________________________ Date _______/_______/_______
French Creek Council, BSA
1815 Robison Road West
Council / District Approval _____________________________________ Date _______/_______/_______
Erie, PA 16509