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Delegation Registration Form Sample

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

Return by January 15, [year]. No reservations can be accepted with a postmark after this date.

TO:    Report to the State Committee
          [Host] Council, BSA
          [Mailing Address]
          [City, State, Zip code]

A.       DELEGATES
We wish to register _______ delegates @ $5 each. (Includes Report to the State patch.)

_______  @ $5 = $ _______

B.       BREAKFAST MEAL
Our council wishes to reserve _______ meals @ $15 each for our delegates and leaders. (Must be paid by January 15.)

_______ @ $15 = $ _______

C.       PHOTOGRAPHS WITH STATE OFFICIAL
We wish to order _______ 5x7 color photographs @ $8 each for our registered delegates.

_______  @ $8 = $ _______

D.       SPECIAL PATCHES
Please reserve _______ additional Report to the State patches @ $4 each.

_______ @ $4 = $ _______


Send check for total amount by January 15.


TOTAL $ _______

 

COUNCIL YOUTH REPRESENTATIVE

(This youth delegate will give the council’s report.)

Name ________________________________________

Rank __________________  Unit _______

Address ________________________________________

City __________________________    Zip _______

 

COUNCIL DELEGATION ADULT LEADER

Name ________________________________________

Address ________________________________________

City __________________________    Zip _______

Council Name ________________________________________

Scout Executive/Adviser Signature ________________________________________