Venturing Gold Award Application

Please print or type all information.  Give month, day, and year for all dates.
Part I – Personal Data:
Name  ______________________________  Nickname _________________________
Address ____________________________________ P.O. Box ___________________
City ________________________________ State ____________ Zip ______________
Telephone ___________________________ Birthdate __________________________
School/College ________________________________________ Grade ____________
Church or Religious Affiliation _____________________________________________
Date Entered Venturing ________________ Date Bronze Earned __________________
_______________________________________________________________________
Part II – Requirements (as they pertain to the requirements for the Gold Award; attach additional sheets as necessary)
A.  Tenure: ____________ months        Qualified: ______________________________
								(Advisor – Signature)
B.  Leadership: __________________________________________________________
      ____________________________________________________________________
      _________________________          Qualified: _____________________________
								(Advisor – Signature)
C:  Participation (district, council, area, regional, national events):
      ___________________________________________________________________
      ___________________________________________________________________
      _________________________           Qualified: ____________________________
								(Advisor – Signature)
D.  Personal Growth (describe briefly at 1 – 6 below):
    1. _____________________________    4.  ________________________________
    2.  ____________________________     5.  ________________________________
    3.  ____________________________     6.  ________________________________
    Approved: _____________________    	Completed: ________________________
		(Advisor/Crew committee – sign)			(Venturer – sign/date)
						Qualified:  ________________________
								(Advisor – sign/date)

Part II – Continued
E.  Crew/Ship Activities (describe briefly at 1 and 2 below):
     1.  ________________________________________________________________
      Approved: ______________________	Completed: _______________________
		(Advisor/Crew committee – sign)			(Venturer – sign/date)
      2.  _______________________________________________________________
      Approved: ______________________	Completed: _______________________
		(Advisor/Crew committee – sign)			(Venturer – sign/date)
F.  Oral Presentation:
      Made before Venturing crew on ________________________________________
							(Date)
						Completed: _______________________
								(Venturer – sign/date)
						Qualified:  ________________________
								(Advisor – sign/date)
G.  Letters of Recommendation/Statements of Venturer’s Conduct:
      _______  School/Church           ______  Employer/Community Leader
      _______  Neighbor/Acquaintance
						Qualified: _________________________
								(Advisor – sign/date)
H.  Presentation (orally and in writing):
     Made before Venturing crew review committee on __________________________
									(Date)
						Qualified: _________________________
							(Review committee chairman – sign/date)
I.  Qualified before 21st birthday?  YES/NO ___  ______________________________
								(Advisor – sign/date)
______________________________________________________________________
Part III  - Certification of Candidate:
Since becoming a candidate for the Gold Award, I have planned, developed, and completed the activities and projects required for qualification for the award. I subscribe to the Venturing Oath, and I consider my conduct to be in keeping with the principles of the Boy Scouts of America.
					_______________________________________
						(Candidate’s signature)
Crew No. ___________
Chartered Organization: _________________________________________________

_____________________________________________________________________
Part IV – Endorsement of Crew Advisor/Crew Committee Chairman:
I/we certify that the candidate is well qualified for the Gold Award, that he/she has fulfilled the requirements for the award, and that he/she has my/our complete recommendation for recognition of this significant achievement.

Advisor  __________________________________________  Date _____________

Crew Committee Chairman ___________________________  Date _____________
____________________________________________________________________
Part V – Council Certification/Recognition:
Region __________  Area ____________ Council ___________________________
							(Name)  			(Number)
This candidate is a currently registered Venturer.  Having completed the requirements for the Gold Award, he/she is to be congratulated for the time, energy, and perseverance required to achieve this recognition.  Presentation of the Gold Award is authorized.

Scout Executive __________________________________   Date ______________

Gold Award Application
No 25-022