Fillable Eagle Scout Palm Application Packet (Page 3 of 4) in pdf

EAGLE SCOUT PALM APPLICATION

BOY SCOUTS OF AMERICA

(Submit to Local Council-Do Not Send To National Office)

Troop, Team, Crew or Ship ________ Local No. _______ Date __________

City ________________________________ State ____________________

The Boy Scout advancement plan of the Boy Scouts of America is for

registered members from joining age until their 18

birthday.

District ____________________________ County ____________________

Members who have completed all requirements for advancement prior

to their 18

birthdays may be reviewed and recognized after that date.

EXPIRATION DATE OF UNIT __________________________________

APPLICATION TO LOCALCOUNCIL

ACTION OF TROOP, TEAM, CREW, OR SHIP

Date of birth ______________________________________

BOARD OF REVIEW

Name ____________________________________________

We hereby certify that this applicant appeared before a board of review on

Address __________________________________________

Date

City, State, Zip _____________________________________

1. He has been actively registered in this unit for at least 3 months since he

I became an Eagle Scout on ___________________________

qualified for the Eagle Scout Award, or qualified for the last Palm.

______________

I was awarded the Bronze Palm (5 merit badges) on

2. He has successfully put into practice the ideals and principles of the Scout

I was awarded the Gold Palm (10 merit badges) on ______________

Oath and Law, the motto “Be Prepared”, and the daily Good Turn.

I was awarded the Silver Palm (15 merit badges) on ______________

3. He has made satisfactory effort to develop and demonstrate leadership ability.

4. He has earned at least five additional merit badges beyond those required for

Eagle or the last Palm.

As the required 3 months have elapsed since I passed the board of review

5. He has participated in a Scoutmaster, coach, or advisor conference.

for the Eagle Scout Award or the _______________ Palm and as I have

now completed the five requirements listed below, I respectfully make application

for the:

For the board of review

Bronze Palm

Gold Palm

Silver Palm

RECORD OF MERIT BADGES

Merit

Unit where registered when awarded merit badge

Badge

No.

Town

State

Date

ACTION OF LOCAL COUNCIL

Date _________________

Approved ________________________

Signature of Scout Executive

MAILING OPTION

After processing, which can take up to two weeks; the Eagle

Palm Application Packet will be mailed to one of the Scout’s

registered Unit Leaders. Please provide the preferred mailing

address below.

*Merit badges may have been earned any time since joining

Name of registered leader: ____________________________

Address: __________________________________________

UNIT LEADERS APPROVAL

This applicant has satisfactorily completed all requirements for the palm

City, State, Zip _____________________________________

Indicated, and I hereby approve his application.

Phone number _____________________________________

____________________________________________________

Signature of unit leader

Date

A Combination of Palms

You may wear only the proper combination of Palms for the number of merit badges you earn beyond Eagle. The Bronze Palm represents

5 merit badges; Gold 10, and Silver 15. For example, if you earn 10 merit badges and two palms, you would only wear the Gold Palm. If

you earn 20 merit badges and four palms; you would wear one Silver Palm and one Bronze Palm.

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Eagle Scout Palm Application Packet Page 3

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