Reporting Merit Badge Counseling Concerns Form

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Reporting Merit Badge Counseling Concerns
Use this form to report to your council advancement committee questionable processes or procedures discovered in merit badge counseling at
group instruction events such as fairs, clinics, workshops, in camp settings, or by individual counselors. Note that reports are primarily for the
information of the advancement committee as methods to improve the merit badge program are considered; however, committees may elect to
follow up on specific cases.
Prior to submitting to your council advancement committee:
a. Consult the Guide to Advancement, section 7, with special attention to topics 7.0.4.6 through 7.0.4.11.
b. Gather information that may help the council advancement committee to understand what has happened. This could include items such
as advertisements or brochures, schedules, any required workbooks or worksheets, or other documentation of the questionable processes or
procedures.
Merit badge(s) __________________________________ Instructor _____________________________ Date(s) of instruction _____________________
Event title (if applicable) _________________________________________________ Sponsor ________________________________________________
Location ____________________________________________________ City _____________________________________ State ____________________
Method of merit badge instruction:
Individual counselor instruction
Summer camp
Merit badge fair/clinic
Outside organization
Other:
Nature of concern (check all that apply):
The merit badge counselor is not registered with the BSA.
The merit badge counselor is not approved by the council advancement committee.
The merit badge counselor did not ensure that each Scout actually and personally completed requirements.
Requirements that could not have been completed were signed off.
Requirements as written were changed or not used.
The Scout was at the event but did not attend class.
The Scout was signed off for a merit badge but did not attend the event.
An outside organization, business, or individual generated a profit from presenting merit badges.
An outside organization, business, or unaffiliated individual presented merit badge opportunities without permission from the BSA.
An outside organization, business, or unaffiliated individual used the BSA brand, trade names, protected images, or logos without permission.
Other:______________________________________________________________________________________________________________________
Statement of facts and concerns. Use additional sheets, if required. Include any comments on steps taken to resolve the issue.
Guide to Advancement topic number related to questionable process or procedure (required): (For example, 7.0.4.6, 7.0.4.7, etc.)
Contact person (should the council advancement committee need more information):
Event coordinator
Camp director
Merit badge counselor
Other: _________________________________________________________
Name _________________________________________________________________________________________________________________________
Phone ______________________________________________ Email ______________________________________________________________________
Have you previously reported this event or counselor?
No
Yes; approximate date of previous report: _______________________________
Submitted by: (*Required)
Name*______________________________________________ District _______________ Unit _______________ Phone* _________________________
Scouting position _______________________________________________ Email* _________________________________________________________
The information presented is correct to the best of my knowledge.
Signature __________________________________________________________________________ Date ________________________________________
Council advancement committee notes
Received by ____________________ Date ________________________________
512-800
2015 Printing

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