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■ Honor your new Eagle Scout
■ Immortalize their project■ Highlight community
achievements ■ Promote the BSA legacy
in a unique, visible way
A new tradition in keeping with Scouting's most distinctive award.
Personalized EAGLE SCOUT® PROJECT MARKER PLAQUE in etched black marble is an impressive way to honor this life-defining award, 8''x10''.
With each plaque purchased, the recipient receives a FREE INITIAL MEMBERSHIP in the National Eagle Scout Association (NESA)!
SKU# 617492 $19999
Order form available at www.scoutstuff.org
Eagle Scout® PROJECT MARKER PLAQUE 617492 - $199 99
Please complete the following information:
Date____________________________ Your Order No. ______________________
SOLD TO __________________________________________________________
Address ___________________________________________________________
City________________________________________ State______ ZIP _________
Telephone _________________________________________________________
SHIP TO ___________________________________________________________
Address ___________________________________________________________
City________________________________________ State______ ZIP _________
Telephone _________________________________________________________
EAGLE SCOUT’S NAME ____________________________________________________________________________________________________________________
Date of Birth _________ _________ _________
Type of Unit _____________________________________________________________________ Unit No. _______________________________________________
City/State ______________________________________________________________________________________________________________________________
Project Completion Date __________________________________________________ Board of Review Date _______________________________________________
Project Description _______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________
Project Location Description _________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________
Location City/State _______________________________________________________________________________________________________________________
Location GPS Coordinates __________________________________________________________________________________________________________________
*Applicable links to a project website or videos (if they exist) _________________________________________________________________________________________
Date
(Troop, Crew, Ship, etc.)
Month Year
Confirmation of transfer to NESA ______________________________________________________________________________________________________________
_____________________________________________________________________________________________ _____________________________________ Signature Date
INTERNAL USE ONLY:
ORDER FORM
*Due to the characteristics of the material, each piece may appear slightly different. Allow up to 4 weeks for delivery.
Please fax or mail to: P.O. Box 7143 • Charlotte, NC 28241-7143 • Fax: 704-588-5822
(Sample: 37.91°N 81.11°W)