Bridal Veil Falls District

Adult Leader History & Service

Name

Address

Zip

Phone #

Work #

E-mail

BUSINESS OR PROFESSION (Give title, company etc.)

CURRENTLY REGISTERED AS:

Stake:

TRAINING

Fast Start

Cub

Scout

Varsity

Venture

Basic

Cub

Scout

Varsity

Venture

Commissioner

Month & Year

ADVANCED TRAINING:

Wood Badge

When

Patrol

Philmont

Month & Year

Other

SCOUTING HISTORY AS A YOUTH:

Cub Scout

Where:

How long?

Rank:

Boy Scout

Where:

How long?

Rank:

Varsity

Where:

How long?

Rank:

Explorer

Where:

How long?

Rank:

YEARS OF SERVICE IN SCOUTING – IN UNITS OR DISTRICT:

Position:

From:

To:

Position:

From:

To:

Position:

From:

To:

Position:

From:

To:

Position:

From:

To:

Position:

From:

To:

Position:

From:

To:

Position:

From:

To:

YEARS OF SERVICE IN SCOUTING – IN DISTRICT, COUNCIL, OR REGION:

Position:

From:

To:

Position:

From:

To:

Position:

From:

To:

Position:

From:

To:

Position:

From:

To:

Position:

From:

To:

SPECIAL SCOUTING SERVICE & SPECIAL AWARDS OR RECOGNITION (Award of Merit, Training Award, etc.)

DISTRICT OR COUNCIL STAFF SERVE ON: (Wood Badge, Timberline, Klondike, Camp-O-Ree, Jamborall, etc.)

ACTIVITIES OUTSIDE SCOUTING: Give resume of service rendered. (Give particular attention to service to boyhood.)

CHURCH:

YOUTH SERVICES (other than Scouting)

PROFESSIONAL OR BUSINESS:

FRATERNAL (Brotherhood Organizations – Elks, Eagles, etc.)

OTHER OUTSTANDING OR UNUSUAL SERVICE (local, state, or national)