■ 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)