Boy Scout Application Packet Page 5
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7BOY SCOUT APPLICATION
Check one
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■
New Boy Scout
Lone Boy Scout
TROOP NO.
EXPIRE DATE
TERM
MONTHS
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Former Boy Scout
Former Webelos Scout
Arrow of Light
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If applicant has an unexpired membership certificate, registration may be accomplished in this unit by paying $1 for processing the transfer. Check the box and attach certificate. It will be
returned by the council.
TRANSFER FROM: COUNCIL NO.
UNIT TYPE
UNIT NO.
Please print one letter in each space—press hard, you are making a copy.
First name (No initials or nicknames)
Middle initial Last name
Suffix
Country
Mailing address
City
State
Zip code
Home phone
Date of birth
mm-dd-yyyy
Grade
Ethnic background (Please mark the appropriate box.)
School
Boys’ Life
African American
American Indian
Alaska Native
Asian
-
-
Caucasian
Hispanic/Latino
Pacific Islander
Other
Parent/Guardian information
Relationship
Guardian
First name
Middle name
Last name
Suffix
Country
Mailing address
City
State
Zip code
Home phone
Date of birth
mm-dd-yyyy
Occupation
Employer
-
-
Business phone
Previous Scouting experience
Youth e-mail address
Parent e-mail address
I have read the attached information sheet and approve the application.
Signature of Scoutmaster
Signature of parent or guardian
Date
Registration fee $
Boys’ Life fee $
.
.
28-209Y
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