NEW-UNIT APPLICATION

NEW-UNIT APPLICATION

Region Council No. District No. National Unit No. Local Unit No. Term (months) Renewal date month and year Pack (C) Crew (P)

Troop (S) Ship (P)

Team (V)

City State Chartered Organization Code

County District Special-interest code For Crew/Ship only

Crew special interest description

Full name of chartered organization

Address Disability code (See instructions)

City State Zip code Trained Leader 100% Boys' Life unit

Executive officer: first name Last name Date of birth First issue Last issue

Address Phone No. Subscription term (months)

City State Zip code No.

Youth registration fees $

Leader registration fees $

Boys' Life fees $

Signature of executive officer Signature (for the council) Charter fee $20.00

Total fees

NEW-UNIT APPLICATION

Region	Council No.	District No.	National Unit No.	Local Unit No.	Term (months)	Renewal date month and year		Pack (C)		Crew (P)
								Troop (S)		Ship (P)
								Team (V)
City				State		Chartered Organization Code

County				District		Special-interest code For Crew/Ship only

Crew special interest description

Full name of chartered organization

Address						Disability code (See instructions)

City		State	Zip code		Trained Leader		100% Boys' Life unit

Executive officer: first name			Last name		Date of birth		First issue		Last issue

Address				Phone No.			Subscription term (months)

City		State		Zip code		No.
							Youth registration fees			$
							Leader registration fees			$
							Boys' Life fees			$
Signature of executive officer				Signature (for the council)			Charter fee			$20.00
							Total fees