Chief Scout Award Application

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CHIEF SCOUT’S AWARD APPLICATION

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Please complete all sections. Completed form to be sent to SCOUTS New Zealand Regional Service Centre.

Surname:       First Name:      


Address:       Phone:      

Email:      
Postcode:       Date of birth:      
Troop:       School year:      
Group:       Personal No.:      
Zone:      

CHIEF SCOUT’S AWARD Date Achieved

SCOUT BADGE      

BRONZE SCOUT AWARD      

SILVER SCOUT AWARD      

GOLD SCOUT AWARD


Outdoors Cornerstone Date Achieved
Personal Development Cornerstone Date Achieved

Camp Craft       Physical      

Expeditions       Social And Life Skills      

Environment       Expression      

Outdoor Skills       Personal Challenges      

Community Cornerstone New Experiences Cornerstone


Emergency Preparedness       National Programme      

Helping Others       Group, Zone or Region      

My Community       Challenges      

Our World/Our Community       Completed      

CHIEF SCOUT’S AWARD


Outdoors Cornerstone       Community Cornerstone      

Personal Development Cornerstone       New Experiences Cornerstone      

Research DOE/Hillary Award       Attend a 3 Day Event      

Attend a Venturer Explained       Prepare a presentation folder      

Zone Scout Leader Discussion       Completed      


ZSL Signature, Print Name and
Email
(Sign as recommendation to Award)

Scout Leader’s name (for delivery of certificate & badge) Address:      
     

Email:       Postcode:      

Phone:       Mobile:      

Date sent:       Date received at Regional Service Centre:      

Approved by National Office Entered into Database ZSL & SL Advised Certificate & Badge Sent

Date Date Date Date


November 2017 566392355.doc

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