Final Eagle Application

EAGLE SCOUT RANK APPLICATION ;j'(f:tHEEAGCE~SCOUT APPLICAN'C-riie'i,ifor;;i;;iiOrii;iliitedoiithis"fo"ii;;tiliii,

C,N,S,W

p~~r8f)Uyon file in your council's office. P!e~$e antB(l:lfl>/~11iS$in9 records or your unifs records. 8e prep~re¢ to fumish copie.s,ol fOUnCI! office so that It may be entered -on to your record.

?~rw'..'l)

NAME ON OFfICIAL

REGISTRATION

j

101772160

CERTIFICATE

NAME

SOCIAL

NO.

SECURITY

\John A. Hoffman

I

1516 Meadow Ln Street

Glenview, IL

Dale joined a Boy Scout troop

VERIFIED

or R F.D Address

02101102

Date became a Varsny Scout

60025

APPLICATION

City, State. Zip

Date became a Venturer

09101105

Date of First Crass Scout board of reviev •...

03119103

Date of Star scout board of review

07129103

(847) 724-4871 Phone

(iIlCIi.J(1H;~J area

code;

Troop

0156

T!'Ut)~" Team, Crt~V'.·.or Ship

Local No.

Werf:; you a Cub Scout?

YES

,,""ereyou a wobeios Scout?

YES

Old you earn the ,.'\.rrow of LrqhlAward?

YES

Had you completed

NO

Glenview, IL Cit:.,'.~~lale. 7ip

the fift!! grade upon jt:.w;ing

(.',GE"Hf::OUiHf Mt-NT ELiGH-Jl iTY Merit liad~J8s,b3dges of rank. and Eagle Palms may be earned by a reg!!::ilered 80y Scout, Varsity ScouL or Venturer. He may earn these awards until his t Sth birthday. /\[1,,/ venture- woo achieved the Firm Class ranI<.as a Boy Scout in a troop or varsity Scoul in a team may continue wo,K;ng for U'1€Star. Ltle. and Eagie Scout ranks and Eaute Palms wlnte lefv:,(er~;d as a Venturer up Io his Hit)) birthday Scouts and venturers who have completed all requirements prior to their f Bth birthday may be reviewed within three months after ttrat date with no explanation. Fa: boards- of review conducted between three and SIX months after the candidate's 18th birthday, Cl statement t)y an adult explammq the reason for ine delay must be attH(:~ll'J(j10 thf' ERQI!-JSGO:H Rank Apphcation when it !s submitted to tile Eaqle Scout Service. The Boy Scout Division at the national office must be contacted for procedures to follow if a boet d of review is to be conducted more than six months after a candtdate:s 18th birthday. ;-;cnu!

f••••

SrH'

(If

Venturer wrlh a

Advaucernuut

!!"j:jy worj, toward rank sovancernent end Procedures lor details.

Comm~t!ee

HI~OLlIHi::MENr

after he is "i 8 years of aqe.

Date

1. 8t'Oactive in your troop. learn. crew or ship for a period of at least six months after you nave achieved the rank of life scoot.

HEOUIRU ...1FN"T2.

Dumonslrale that you live by the principles of the SCOU! Oath and Law in your (~a'ly lilfe. Lis! the «ames of individuals be w~mng to prov.de a recommencaucn on your behalf

NAME

He!iq~Gus

\\ rl -tttm'V'~---

~

_5~~t_ft~~_~~

~o~

~_________

Earn a toter of 21 merit hadges (mcluding 12 required badges).

I

HE(:iUIHEMEr-r!'

i

3.

~lERIT

--

-- "ATE'

BADGE

!".-;CAMPING- -

',"",=T

--"

ARNE\:)

-.. , ,

....'- ... -,.,-

'-''''''''-T',;:;,,;;~;;='''"l MERIT~~~:C7"~-~-"-~~~~:EDj

L........

----9i15i64--~

'-~'-'C;'''''''7C'''''''' _","

l-fJ11-- - CftiJ -5Co2l

List the month. day, and year the merit badge V:3S earned.

"C'C 'cC~'.-,-·

""'.

.

-

..

. .

G,;~asketry.

L_ L.

-, -

.

.' t,~rs.

. j

D3119/03

i

i8/01io3-j

, ',-,'

~----P5)22io41 .

4"

-'1"

J

.

_ •• -

7~hemistry,

1·:- - t. "- .-.- -"".,,,,--., ..,.--,".-"+L·'··~-'7--'-'·-'·'-'" 15. FOMMUNICATIONS .', '0. LIFESAVING

1~2z-«:{~-<5Ll-2--18'T\-a~"t-= ~~q _1~)f

BADGE

12:tTfliENSHfpli;{THECOMMUNiTY--'57i1i04-~ 1:1:' blfiiENSHIP iNTHENA'i16if'''-c, -'!i-,oa/04 ~ i4-.-~rrIZENSHfP"i'NTHEW6RC5-"'-C- ~-'''. t. ,-..\,.

~~_

-RIT

and 'J'.Io=;I(J

\-_ q'5L-i - l2v~ -- ~r \- ff-l1-S1-3 -iH~r

J<;\O__~~

____

10/13/04

\- 8 '-ll- - 1-2--t.{~ 1'B-=H

~

~
q'/-kt~,____

'tv\\()IA.d!t- ~v-

Two oilier references

~~9

Le.cl-tV\t-C_ - -~--~ _t{Otl.tv-l~)cJl~

.,- QM_

i":nlpiu:>'el {If <';nyi

.•.••• ho know you personally

10127190

TELEPHONE

1 M~-------~ _~Sll,L_

~~Q~_~_~

f-kid-;

Educaucnai

Dale of Life Scout b.;:X·H d of review

ADDRESS

~

P:::lrf.'()t~:i9!;ardj~·m':

of B,,'"

j;;;;.~:::j p

----lS703ios-"

~"-"":f~;,~1,/0:': Htq:;!re.rj t).'Icl!.)i;'; b !l)?'Y be E.mergency Preparedness or Lifesaving l~eq;;:r('Jd 1)ad~Je 9 may be Cvclinq, Hiking or Swimming

• Paqe 1-

"NT 4,

\'N!1ile a Life Scout, serve actively far period 01 six months in one or more of the tonowmq positions of responsibiuty. Boy Scout troop. V •.arsny

Scout team.

Venturing

(

Capl<3II"Lcocapta.n.

crew/ship

prO{Ju.ml rnanaqer squad teader, tearu secretary, librarian. quartermaster,

President. vice-president,

secretary. treasurer.

POSITION

FROM

TO

Troop Assistant Senior Patrol ~:ader

06/01105,.

MI01l06

!-(t;·:(JU!F~f:".VF.NT S

List only those positions served after Life board of review date.

P•.~lroileader. assistant senror patrol leader, senior patrol leader , troop guide. Order of the Arrow troop representative, juruor aselstcru Scoutmaster. chaplain aide. instructor, historian. Venture patrol leader

boatswain,

boatswain's

den chief scribe, librarian,

chaplain aide, instructor, den chief, Orc.ler of the Arrow team representative

mate. yeoman. purser, storekeeper

POSITION

FROM

Date of Lite SCOUi board ot review

TO

10113/04

VVtllle a IAe Scout, plan, develop, and give leadership to others in a service project helpful to any re!lgious mstituttou, any scnoor, Dr YDUr commun'ty. The project idea must he approved by your Scoutmaster ann troop committee find by the council or distnct before you start. You must use the Eagle Scout Leadership Service Project Workbook, No. 13~927, in meeting this requirement.

04120108

Date project was completed

r~COU!Rt~~vlf:NT r,

Attach to ttus apphcauon a statement of your arnbitions and life purpose and a I;st!ng of posmons held in your rehpious institution, school. camp, community, or other orqanizanons, !.~uring which you oeroonstreteo teeoersrnp skills. tnc'uoe honors and awards recer ved cunnq tbrs service. Take pari in a Scoutmaster conference with your unit leader.

Date conference

CE

all statements

on this application

are true

ano correct

All requirements

06106108

was !·lelcj

were completed

prior to rn~f 18th birthday.

c.tf;~ ~__

TeiePhonelj{1-f-:}~tJ-I

Stqnature of ;:·'pf-'iicw):

[~'I~-I··;r1t~I~1

Dale

__

Month

UNlT ;.\PPf,OV/\L

(persona! siqnatcres

'gnd'_iCecfun,tte"der

"

--w"

1"·

.re oturnt

, ,.

?~_

CF.RT :FIC;I\·j10N.

_

I)

Telephone~~·

; •.ccordmn to the records or this council, the applicant is

~:"~Flf"f1

Positlon~._

7b~X=~l2--_-

Telepi10nL~T

4~d~, ,__ ~

J1~ fA!

chair

Review dale

OF f~EV![:~V.

[ITf MOlllh

<'I

D::!y

.~. __._.._

__

_ _.

_._ .

07102108

was approved.

This dale will be used on the Eaqle Scout credentials

Siqnalure Commutes

Policies and Procedures,

have been followed.

of council/district

board representative

Of applicable}

! approve this application.

r'~r--I' L~~,L ,,__ r-~l'-.'J-', '~l

Dale ...__.

.__ .

._.~._~

L-~','=

~,~~

MonU.

Presentation of the rank may not be made until the Eagle Scout credentials the BSA local council

are received by

r

Day

EAGLES~bJT SERViCE VAUDATION!

The National F:'::J~J!e Scout Assocration is a fellowship of men who have achieved the Eagle SCGut (ani". Mernhership embraces the top achievers of the Boy Scouts of America. Benefits mcludu a subscription to Eagletler. The journal keeps NES,l\ members informed on SCOl.ilH·ll~ in 90ner;::iI and Eagi(') Scouting in particular. Applications

art: 8V~lH<·!bk-~ 31 your local council service center.

Requfar flve··Yf·lar memberships

OF THIS APPLlCATiOl'

5B~7~~8~:

Year

member of U·1!Sunit anc all dates listed are correct

Day

Si£J tature 01 board chue-man

EDiTiONS

Year

[~~Jl~fi'I~I~

Date

-_~

Day

tv1:),",!!";

reqrslered

_ _._.

Month

~4- ;J. -_i-_~P(_,:,9'4 5 ~

--

The applicant appeared before the Eagle Scout board of review on this dale and th~s application

! certify that all procedures, as outlined in Advancement

Scout Exocuuve

Year

[fJ~ __ e]~jzl

Date

Date

BY EAGLE SCOUT 80ARD

Day

requrred)

~

conunittee

r:~sJ.\ LOCAL C()UNC!L

I\CTIONS

quartermaster.

PHEVIOUS

TO THE

are $2~). Life memberships

are S180.

2002 REViStON SHOULD NOT BE USED

2002 Boy Scou!.;; of America

MPage2M

10

9

8

5

"

__ ,'=,

Year

J

!

~';offman

/I'

ERROR

REPORT

f' d - app I"ication ven'f'Ied- . Obtain signatures and present to board of review ~() errorsoun

END OF REF'ORT

lI

02-JUL-08