February 8, [year], Report to the State and Scout Parade

Please send this listing of your official delegation with the Council Delegation Registration Form to the [host] Council. Please indicate the official report delegates, and your council’s youth representative.

Youth Delegation

*Indicates report delegate
**Indicates council youth representative

Council Delegation Adult Leader

Name _______________________________________

Address _______________________________________

City, Zip ___________________, __________

Phone ___________________

E-mail _______________________________________