VICTORIAN ROVER SCOUTS

Application for the Presentation of the Baden-Powell Award

Part A: Personal Details Membership No Region

Name NAME IN BLOCK LETTERS Please ensure this is correct, as this is the name that will be inscribed on the certificate

Address Suburb Postcode Phone Mobile Email Date of Birth

Part B: Details and Experience

Crew Group District Investiture Date Joey Scouts Cub Scouts Scouts Venturer Scouts Rover Scouts yrs yrs Yrs yrs yrs

Part C: St George Award Details

Award Component & Details Date Squire Training Badge completion Details

Rover Skills Badge completion Details

Physical Badge completion Details

Service Badge completion Details

Part D: Baden-Powell Scout Award Details

Award Component Date St George Award completion Community Development Badge completion Details

Personal Growth Badge completion Details

Part E: Baden-Powell Scout Award Support Team – Self-Reflection Interview

Award Component Date Self-Reflection Interview

Part F: Rover Crew Approval (please complete section below) I verify that the necessary qualifications as listed above have been completed and the Rover Crew recommends this applicant be awarded the Baden-Powell Scout Award

Name Position Signature Date

Part G: Region Rover Community – Notification

Name Position Signature Date

Part H: Victorian Rover Council – Endorsement

Name Position Signature Date

Part I: State Chief Commissioner – Approval

Name Signature Date

______Part J: Badge Return (Rover Crew to Complete) Following the approval by the State Chief Commissioner the BPSA Badges and Certificate should be sent to the person listed below who will arrange for the presentation to the Rover Scout.

Name Position Address Suburb Postcode Phone Mobile Email ______Part H: State Office Use Only

Date Applicant notified of outcome by Letter Date CL, RA, GL, DC and RC advised

Date Award noted on Extranet Record (Must be after Applicant has been advised)

Version 1, August 2014