Revised BSP Form No. 17 Merit Badge Application Form PDF
Revised BSP Form No. 17 Merit Badge Application Form PDF
Revised BSP Form No. 17 Merit Badge Application Form PDF
07-24-12)
_____________________________________
(Signature over Printed Name)
APPROVED:
______________________________________________
(Signature over Printed Name of Troop Leader / Outfit Advisor)
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.
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) (Signature over Printed Name of Merit Badge Counselor)
NOTE: Do not examine Scout unless application is approved by the Troop Leader / Outfit Advisor. Only certified Advancement
Counselors are authorized to sign his certificate.