EAGLE CANDIDATE STATISTICS FORM

Revised Feb 2011

(To be filled out by the District)
FOR COUNCIL USE ONLY
District #__________

Sub District #_________

Sub District Name (Stake/ Zone)

Registered in Unit: Troop, Team, or Crew

________________________________________________

_______________________
District

_____________
Unit Num

__________________________________________
Name (First
Middle
Last)
__________________________________________
Address
_____________________
City

____ ____________
State Zip Code

(______) _____________
Phone Number

__________________
Date of Birth

__________________

__________

Eagle Board of Review Date

Current Age

FOR COUNCIL USE ONLY

Received From:

___________________

Date Received:

___________________

Date to National:

___________________

Notes:

___________________________________________
Organization Benefiting from Eagle Project
_____________________
Contact Person

(____) _____________
Phone Number

_____ Total Personal Hours

_____ Number of Helpers on the Project
_____ Hours spent by helpers on the project
_____ Total hours spent on the project
_____ Total dollar amount spent on the project
748 North 1340 West
Orem, Utah 84057
P 801-437-6222 | F 801-437-6240
www.utahscouts.org

Please write a specific past tense sentence that

summarizes the Eagle project.
_________________________________________
_________________________________________
_________________________________________