Request Form For Extension Of Time To Earn Eagle Scout Rank

ADVERTISEMENT Request for Extension of Time to Earn Eagle Scout Rank
Check if this is for extension of time to earn Quartermaster rank
OR Venturing Summit Award
“If a youth foresees that, due to no fault or choice of his own, he will be unable to complete the Eagle Scout rank requirements
before age 18, he may apply for a limited time extension. These are rarely granted and reserved only for work on Eagle.”
—Guide to Advancement
Before completing this form, please refer to the Guide to Advancement, “Time Extensions,” It outlines the circumstances
under which an extension may be considered, and the process tha
advancement records in the BSA system are up to date before submitting this request.
Candidate’s name _____________________________________________________________ PID No. ________________________
Date __________________ Council name or headquarter city ______________________________ Council No. __________________
Date of birth _________________
__________________ Life board of review date __________________
Current unit membership—choose one:
Unit No. _____________________
All of the following must be included with this application (Incomplete extension requests will be returned.):
Written statements (or interview summaries) from persons with knowledge of the case
position statement (such as meeting notes, statement from a health professional if applicable, etc.)
All requests, letters, and position statements must include the date and signature of the author or committee chair.
Please provide a brief summary of circumstances preventing completion of requirements prior to 18th birthday.
Use this space or attach a summary. Please limit the summary to 150 words or less.
The council advancement chair and staff advisor are to select at least two council advancement committee members who research
a request for extension. Their names and contact information, along with others requested below must be provided. They may be
contacted as this case is considered.
Position or Relationship
Preferred Phone No.
Email Address
Council advancement chair
Council advancement staff advisor
Council advancement committee member
Council advancement committee member
Unit leader
I certify the procedures regarding time extensions as outlined in the Guide to Advancement were followed, and based on our council
advancement committee’s research, I recommend the following decision:
No. of months of extension recommended _____________
Scout executive’s signature _____________________________ Date request submitted ____________________________________
Send this signed form and all required documents and evidence noted above to the National Advancement Team:
U.S. Postal Service, UPS, Federal Express, etc.
S272, 1325 W. Walnut Hill Lane, Irving, TX 75038
This form is available for downloading at
2015 Printing


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