BSP Form No. 10 (Rev.

04-05-12) (to be accomplished in Quadruplicate)

BOY SCOUTS OF THE PHILIPPINES

ILIGAN CITY Council

APPLICATION FOR EAGLE SCOUT RANK

(To be submitted to the Regional Office)

Date FEBRUARY 17, 2024

THE NATIONAL COURT OF HONOR
Boy Scouts of the Philippines
Manila

Dear Sir/Madam:

I would like to formally express my sincerest intent to apply for the Eagle Scout Rank, the highest rank in Senior Scout Advancement,
please do accept my application and consider myself as an Eagle Scout Candidate.

In addition to satisfying the necessary requirements for the Explorer, Pathfinder, Outdoorsman, and Venturer Scout Ranks, I am now
qualified and prepared to appear before the National Board of Review for Eagle Scout, after the successful completion of the minimum number of
Merit Badges required and specified for the Eagle Scout Rank.

I state On My Honor that I have, as a true Scout; I lived up to the ideals of the Scout Oath and Law and promoted the Scout Spirit among
my fellow Scouts. I also have conscientiously tried my best to develop my leadership ability while helping other young people to become better Scouts

I respectfully submit my registration and advancement records for your consideration, as follows:

Applicant’s Signature Date of Birth: FEBRUARY 13, 2006 Age: 18

Membership ID Card No.: 12685597
JERIC DAVE L. RECUSTODIO Date of Registration: JANUARY 23, 2024
Full Name in Print Valid Until: JANUARY 23, 2025
Registered as a Senior Scout of Outfit No. 118 , Sponsored by the ILIGAN CITY NATIONAL HIGH SCHOOL
Position in the Outfit:SENIOR CREW LEADER No. of years as a KAB Scout ______ as a Boy Scout ______ as a Senior Scout 2 YEARS & 11 MONTHS
Became an Outdoorsman Scout Rank holder on SEPTEMBER 10, 2022 Became a Venturer Scout Rank holder on MARCH 25, 2023
(Date Certificate Issued) (Date Certificate Issued)

Merit Badge Earned. (Corresponding approved applications for these Merit Badges are attached)
MERIT BADGE SPECIFIC MERIT BADGE NAME OF MERIT BADGE DATE APPLIED DATE PASSED
GROUP SUBJECT COUNSELORS (mm-dd-yr) (mm-dd-yr)
PUBLIC SERVICE 1. Safety ES DARREN T. ADRALES JUNE 4, 2021 JULY 10, 2021
CITIZENSHIP 2. Citizenship in the Home ES JED YUCEL L. RECUSTODIO JULY 10, 2021 AUGUST 03, 2021
CITIZENSHIP 3. Citizenship in the Community REV.FR. MSGR.ALBERTO S DE LARA OCTOBER 2, 2021 DECEMBER 12, 2021
PUBLIC SERVICE 4. First Aid ES JESHANZ L. AMARGA WBH/CML DECEMBER 12, 2021 JANUARY 07, 2021
CITIZENSHIP 5. Filipino Heritage JAYFFER G. REGIS NOVEMBER 30, 2021 DECEMBER 30, 2021
NATURE 6. Ecology or Tree Parenting HANIFAH D. PINTO OCTOBER 09, 2021 DECEMBER 05, 2021
CITIZENSHIP 7. Citizenship in the Nation CLARK KENT F. BATUCAN WBH/CML JUNE 04, 2022 SEPTEMBER 02, 2022
SPORTS 8. Physical Fitness FRACKY JUN S. PABILAR FEBRUARY 05, 2022 MARCH 31, 2022
SPORTS 9. Swimming ES JAMES MARK E. MORIN JUNE 04, 2022 AUGUST 20, 2022
NATURE 10. Soil and Water Conservation HANIFA D. PINTO APRIL 05, 2022 MAY 14, 2022
NATURE 11. Weather HANIFA D. PINTO MAY 21, 2022 JULY 09, 2022
PUBLIC SERVICE 12. Emergency Preparedness ES JAMES MARK E. MORIN DECEMBER17, 2022 MARCH 04, 2022
CAMPCRAFT 13. Camping EDGAR MIGUEL B. PARENO JR., WBH DECEMBER 17, 2022 MARCH 04, 2022
Specialist Rating: 3 14. Hiking ES JESHANZ L. AMARGA WBH/CML SEPTEMBER 03, 2022 DECEMBER 23, 2022
related Merit 15. Pioneering CLARK KENT F. BATUCAN WBH/CML DECEMBER 17, 2022 MARCH 04, 2022
Badges subject 16. Rope Work ES JAMES MARK E. MORIN SEPTEMBER 24, 2023 DECEMBER 28, 2023
PUBLIC SERVICE 17. Life Saving ES ALEXANDER A. RACMAT JR. MAY 19, 2023 JULY 08, 2023
CITIZENSHIP 18. World Brotherhood EDGAR MIGUEL B. PARENO JR., WBH JUNE 10, 2023 OCTOBER 22, 2023
Specialist Rating: 3 19. Firemanship ES JAMES MARK E. MORIN APRIL 13, 2023 OCTOBER 22, 2023
related Merit 20. Personal Health CLARK KENT F. BATUCAN WBH/CML AUGUST 22, 2023 NOVEMBER 04, 2023
Badges subject 21. Electricity ROMMEL T. LIM APRIL 7, 2023 OCTOBER 22, 2023
NATURE 22. GO Green Merit Badge ES JESHANZ L. AMARGA WBH/CML OCTOBER 08, 2023 DECEMBER 01, 2023
NATURE 23. GROW Green Merit Badge ES JESHANZ L. AMARGA WBH/CML DECEMBER 01, 2023 FEBRUARY 03, 2024
CHARACTER CERTIFICATION Date: FEBRUARY 10, 2024

As a result of our personal knowledge and observation, we the undersigned, hereby certify that the Eagle Scout Candidate has proved
himself/herself to be a true and worthy Scout by living up to the Ideals of the Scouting Movement.

ES JED YUCEL L. RECUSTODIO ARTSON LENDL L. ACIBAR, WBH

, Parent’s/Guardian’s Signature Outfit Advisor’s Signature

REV.FR.MSGR. ALBERTO S. DE LARA CHRISTY T. ATOK

Religious Adviser’s Signature Class Adviser’s Signature

ACTION OF COUNCIL COMMITTEE ON ADVANCEMENT

We hereby certify that the applicant has furnished the committee satisfactory and concrete evidence that:
1. The Scout candidate has maintained an active registered relationship to Scouting for more than 2 YEARS____ _ since he
became a Venturer Scout Rank holder, and (no. of years/months)
2. He/She has made a satisfactory effort to develop and demonstrate leadership ability and
3. He/She has satisfactorily put into practice the Ideals and Principles of the Scouting Movement.

The committee on Advancement, therefore, recommends approval of this application.

Chairman, Committee on Advancement Date Council Program Commissioner

Signature Over Printed Name Signature Over Printed Name

ACTION OF LOCAL COUNCIL OFFICE

Respectfully endorsed to the Regional Office, BSP, with the recommendation that the Special Board of Review for Eagle Scout
be held as follows:

Date: Time: Place:

ACTION OF THE NATIONAL BOARD OF REVIEW

FOR EAGLE SCOUT RANK Council Scout Executive / OIC
Signature Over Printed Name

This is to CERTIFY that the Eagle Scout candidate appeared

before the National Board of Review for Eagle Scout Rank on ACTION OF THE REGIONAL OFFICE
, held at
(Date of the Board of Review)
Processed by:
, and has satisfied Date received by the Regional Office:
the Board that he/she is qualified for the Eagle Scout Rank. Board Constituted:

RECOMMENDING APPROVAL

Chairman of the Board of Review

Regional Scout Director

ACTION OF THE NATIONAL OFFICE

Member Member APPROVED:

Date SECRETARY GENERAL

Member Member
Certificate Badge / Issued:
NOTE: Please write your name in print, neatly and legibly before your signature. Medal Issued: No.:
Posted / Recorded:
IMPORTANT: This form must be accomplished in QUADRUPLICATE, and must be submitted to the Regional Office, BSP for endorsement. If approved, Original
Copy is retained at the National Office; Duplicate copy is sent to the Regional Office; Triplicate and Quadruplicate copies sent to the Local Council Office and the
Eagle Scout candidate.