APPENDIX

2A

Council Notification of Religious Recognition Earned

Please complete the form below and send it to: [name, title, council address].

Recipient’s name _______________________________
Age _________________________________________
Address _____________________________________
City ___________________ Zip Code ______________
Daytime Phone ________________________________
Program Level: 

Daisy Brownie Junior Cadette Senior Adult

Troop/Group # _______________________________
Service Unit _________________________________
District _____________________________________
Name of Recognition ___________________________
Date Completed _______________________________
Date Recognition Received  ______________________
Location Recognition Was Received _______________
Religious Institution Contact _____________________
Phone ______________________________________

2A-12

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