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BSP Form No. 17 Rev. 07-24-12 BOY SCOUTS OF THE PHILIPPINES National Office Manila MERIT BADGE APPLICATION Date Date of Merit Badge Application is applied for I hereby certify that I have been a holder of Scout s complete name in block letters Present Scout Rank/Badge Date passed the Board of Review Troop / Outfit No. Sponsoring Institution and that I am qualified to work on the requirements for the Merit Badge. Signature over Printed Name APPROVED NOTE Upon signing this Merit Badge Application the Troop Leader /Outfit Advisor recommends and sets an appointment with an accredited/certified Merit Badge Counselor on specified dates of Merit Badge Counseling/Examination* MERIT BADGE COUNSELING APPOINTMENT Merit Badge Requirements / Projects Submitted and Completed Troop Leader/ Outfit Advisor Merit Badge Counselor Signature Date of 1st Meeting Date of 2nd Meeting Optional when requirements are NOT satisfied during the 2nd Meeting NOTE This portion MUST filled-out by the Scout who appears before the Merit Badge Counseling/Examination and MUST be signed by the Troop Leader / Outfit Advisor and the Merit Badge Counselor as proof of completion for Merit Badge requirements. THIS IS TO CERTIFY that the above-named Scout personally appeared before the undersigned and that after a careful examination of said Scout on the subject has satisfactorily passed the test for Merit Badge Subject Date Passed the Merit Badge Requirements NOTE Do not examine Scout unless application is approved by the Troop Leader / Outfit Advisor. Signature over Printed Name APPROVED NOTE Upon signing this Merit Badge Application the Troop Leader /Outfit Advisor recommends and sets an appointment with an accredited/certified Merit Badge Counselor on specified dates of Merit Badge Counseling/Examination* MERIT BADGE COUNSELING APPOINTMENT Merit Badge Requirements / Projects Submitted and Completed Troop Leader/ Outfit Advisor Merit Badge Counselor Signature Date of 1st Meeting Date of 2nd Meeting Optional when requirements are NOT satisfied during the 2nd Meeting NOTE This portion MUST filled-out by the Scout who appears before the Merit Badge Counseling/Examination and MUST be signed by the Troop Leader / Outfit Advisor and the Merit Badge Counselor as proof of completion for Merit Badge requirements. THIS IS TO CERTIFY that the above-named Scout personally appeared before the undersigned and that after a careful examination of said Scout on the subject has satisfactorily passed the test for Merit Badge Subject Date Passed the Merit Badge Requirements NOTE Do not examine Scout unless application is approved by the Troop Leader / Outfit Advisor.

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