Troop 889 Merit Badge Counselor Form

Thank you for your interest in becoming a Merit Badge Counselor.

Please fill out this form in it's entirety before submitting. Please note that this form
replaces your current registration, so mark all the merit badges you are interested in supporting.

	* Required
Your First Name:*
Your Last Name:*
Your Email Address:* (The address which Boy Scouts can contact you easily.)
Your Phone Number:* Format: (999) 999-9999
Youth Protection Training Date:* (The date of your most recent YPT.)	(MM-DD-YYYY)
Are you interested in being a Tall Timbers MBC?	Yes, I'll help other troops too. No, only Troop 889.
Merit Badge: (Please select the Merit Badges you want to instruct.)
YES NO Merit Badge American Business American Cultures American Heritage American Labor Animal Science Archaeology Archery Architecture Art Astronomy Athletics Automotive Maintenance Aviation Backpacking Basketry Bird Study Bugling Camping * Canoeing Chemistry Cinematography Citizenship in the Community * Citizenship in the Nation * Citizenship in the World * Climbing Coin Collecting Collections Communications * Composite Materials Computers Cooking Crime Prevention Cycling * Dentistry Disabilities Awareness Dog Care Drafting Electricity Electronics Emergency Preparedness * Energy YES NO Merit Badge Engineering Entrepreneurship Environmental Science * Family Life * Farm Mechanics Fingerprinting Fire Safety First Aid * Fish and Wildlife Management Fishing Fly-Fishing Forestry Gardening Genealogy Geology Golf Graphic Arts Hiking * Home Repairs Horsemanship Indian Lore Insect Study Journalism Landscape Architecture Law Leatherwork Lifesaving * Mammal Study Medicine Metalwork Model Design and Building Motorboating Music Nature Nuclear Science Oceanography Orienteering Painting Personal Fitness * Personal Management * Pets YES NO Merit Badge Photography Pioneering Plant Science Plumbing Pottery Public Health Public Speaking Pulp and Paper Radio Railroading Reading Reptile and Amphibian Study Rifle Shooting Rowing Safety Salesmanship Scholarship Scuba Diving Sculpture Shotgun Shooting Skating Small-Boat Sailing Snow Sports Soil and Water Conservation Space Exploration Sports Stamp Collecting Surveying Swimming * Textile Theater Traffic Safety Truck Transportation Veterinary Medicine Water Sports Weather Whitewater Wilderness Survival Wood Carving Woodwork
Carpentry (Centennial) Pathfinding (Centennial) Woodwork (Centennial) Tracking (Centennial)
* Eagle required Camping, Citizenship in the Community, Citizenship in the Nation, Citizenship in the World, Communications, Environmental Science, Family Life, First Aid, Personal Fitness, Personal Management, Emergency Preparedness OR Lifesaving, Cycling OR Hiking OR Swimming