EAGLE SCOUT PALM APPLICATION BOY SCOUTS OF AMERICA

(SUBMIT TO LOCAL COUNCILDO NOT SEND TO NATIONAL OFFICE)

Troop, Team, or Crew ___________ Local No. _ _____________ Date _ ___________ The Boy Scout advancement plan of the Boy Scouts of America is for registered members from joining age until their 18th birthday. Members who have completed all requirements for advancement before their 18th birthday may be reviewed and recognized after that date. City _____________________________________________ State ______________ District _ ____________________________ County ___________________________ EXPIRATION DATE OF UNIT _ ___________________________________________

APPLICATION TO LOCAL COUNCIL

Name ______________________________________________________
Print

ACTION OF TROOP, TEAM, OR CREW COMMITTEE BOARD OF REVIEW

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

Address _ ___________________________________________________ City, State, Zip _ ______________________________________________ I became an Eagle Scout on _ ___________________________________ I was awarded the Bronze Palm (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 review 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 award of the: Bronze Palm

1. He has maintained an active registered relationship to Scouting for 3 months since he qualified for the Eagle Scout Award, or since he qualified for the ________________________ Palm. 2. He has satisfactorily put into practice the ideals and principles of the Scout Oath and Law, the motto Be Prepared, and the daily Good Turn. 3. He has made a satisfactory effort to develop and demonstrate leadership ability. 4. He has earned at least five additional merit badges* beyond those required for Eagle or last Palm. 5. He has participated in a Scoutmaster, Coach, or Advisor conference.

Gold Palm

Silver Palm
__________________________________________________________
For the board of review

RECORD OF MERIT BADGES

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

ACTION OF LOCAL COUNCIL

Date _ ______________________ Approved _ _____________________
Signature of Scout executive

LOCAL COUNCIL RECORD

1. Checked _ _______________________________________________ 2. Certificate prepared _ ______________________________________

UNIT LEADERS APPROVAL

This applicant has satisfactorily completed all requirements for the Palm indicated, and I hereby approve his application.

3. Award made _ ____________________________________________ 4. Posted to the District Advancement Report Summary ______________________________ 5. Filed in unit history folder _ __________________________________

Signature of unit leader

Date _ _______________________________________________________

*NOTE: These merit badges may have been earned anytime since joining.

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 wear only the Gold Palm. If you earn 20 merit badges and four Palms, you would wear a Silver and a Bronze Palm.
2008 Printing

58-709

30176 31521