Wood Badge Application

Name: ______________________________________

Address:______________________________________

City: ______________________   State: ___________       Zip Code: ____________

Date of Birth: ___________________

Phone: (H) ________________________  (W) ___________________

Council: ___________________________   District: _____________________

Unit:   Type of Unit: __________________

           Unit Number: _________________

Years in Scouting ---- Boy: ____________  Adult: _____________

Current Position(s): _______________________________________

______________________________________________________

Special Needs and Concerns: _______________________________

______________________________________________________

______________________________________________________

Email address: __________________________________________

T-Shirt Size: (Mens' Sizes)

S ______ M ________ L_______ XL _______ 2X ________ 3X _________

Amount Enclosed: ___________

Cost for the Wood Badge Course is $200 before June 1, 2008 or $225 after June 25. A $75 deposit is required with your application to reserve your space in the course.

Mail applications to:

Buckskin Council
2829 Kanawha Blvd E.
Charleston, WV  25311