Senator Mike Bernskoetter

Resolution Fact Sheet - Eagle Scout


First, please give us your name, address, phone and email address.

Name:
Address:
City:
State:
Zip:
Phone:
Email address:

Now we need information regarding the resolution.

Date Resolution Needed: (mm/dd/yyyy)
Name of Scout:
City of residence:
Names of parents:
Date and place of Eagle Court of Honor:
Troop number:
Total number of years in scouting:
Number of merit badges:
Leadership positions held (such as Patrol Leader, Scoutmaster, Historian, Troop Guide, etc.):
Special awards and/or honors: (such as Order of the Arrow, Tribe of Mic-O-Say, World Conservation Award, Mile Swim, etc.):
Major Scouting activities (such as High Adventure trips, camporees, summer camps, etc.):
Brief description of Eagle project:
Other pertinent information:
Mailing instructions: