EAGLE SCOUT PALM APPLICATION == BOY SCOUTS OF AMERICA(SUBMIT TO LOCAL COUNCIL–DO NOT SEND TO NATIONAL OFFICE)

The Boy Scout advancement plan of the Boy Scouts of Americais for registered members from joining age until their 18th birth-day. Members who have completed all requirements foradvancement prior to their 18th birthday may be reviewed andrecognized after that date.

Troop, Team, or Post Local No. Date

City State

District County

EXPIRATION DATE OF UNIT

APPLICATION TO LOCAL COUNCIL

Name Print

Address

City, State, Zip

I became an Eagle Scout on I was awarded the Bronze Pal (5 merit badges) on I was awarded the Gold Palm (10 merit badges) on I was awarded the Silver Palm (15 merit badges) on

As the required 3 months have elapsed since I passed the board of reviewfor the Eagle Scout Award or the Palm and as I havenow completed the five requirements listed below, I respectfully make appli-cation for the award of the:

Bronze Palm o Gold Palm o Silver Palm o

RECORD OF MERIT BADGES

*MERIT Unit where registered when awarded merit badgeBADGE No. Town State Date

UNIT LEADER’S APPROVAL

This applicant has satisfactorily complete all requirements for the palmindicated, and I hereby approve his application.

Signature of unit leader

Date

ACTION OF TROOP, TEAM, OR POST COMMITTEEBOARD OF REVIEW

We hereby certify that this applicant appeared before a board of reviewon

Date

1. He has maintained an active registered relationship to Scouting for 3months since he qualified for the Eagle Scout Award, or qualified forthe ___________________________Palm.

2. He has satisfactorily put into practice the ideals and principles of theScout Oath and Law, the motto “Be Prepared”, and the daily Good Turn.

3. He has made a satisfactory effort to develop and demonstrate leadershipability.

4. He has earned at least five additional merit badges* beyond thoserequired for Eagle or last palm.

5. He has participated in a Scoutmaster, Coach, or Advisor conference.

For the board of review

ACTION OF LOCAL COUNCIL

Date Approved Signature of Scout executive

LOCAL COUNCIL RECORD

1. Checked 2. Certificate prepared 3. Award made 4. Posted to the District

Advancement Report Summary

5. Filed in unit history folder

NOTE: These merit badges may have been earned anytime since joining www.VikingBSA.org

A Combination of PalmsYou may wear only the proper combination of palms for the number of merit badges you earn beyond Eagle. The Bronze Palmrepresents 5 merit badges; Gold, 10; and Silver, 15. For example if you earn 10 merit badges and two palms, you would wearonly the Gold Palm. If you earn 20 merit badges and four palms, you would wear a Silver and a Bronze Palm.

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