Hornaday Application Form – Fill Out and Use This PDF

B A D G E

Application for the

William T. Hornaday Badge

Name ________________________________________________________ Date of birth ______________________

Applicant’s address _______________________________________________________________________________

City ______________________________________________ State _________ Zip code ______________________

Current Registration. Check one and indicate unit number:

Boy Scout:

Rank at time of application ______________________ Became a First Class Scout on ___________________

(DATE)

Venturer:

Check the awards that you have earned as a Venturer:

■ Bronze Award	■ Quest Award
■ Gold Award	■ Ranger Award
■ Silver Award	■ Quartermaster Award
■ Trust Award	■ Other _____________________________________
Council ________________________________________	District _________________________________________
Council No. ____________________________________

Unit leader’s name _______________________________________________________________________________

Telephone No. _______________________________

Conservation adviser’s name ______________________________________________________________________

Professional conservation affiliation _______________________________________________________________

Telephone No. _______________________________

Statement of Applicant

I have thoroughly read the requirements for this award. I have worked closely with my conserva- tion adviser in the design and execution of each project. The work summarized in this application is of my design. I request consideration for receiving the William T. Hornaday badge.

Applicant’s signature _________________________________________________ Date ______________________

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B A D G E

Additional Requirements for the

William T. Hornaday Badge

Boy Scout:

Complete the requirements for any three merit badges shown in boldface, as well as any two others from this list.

MERIT BADGE	DATE COMPLETED	MERIT BADGE	DATE COMPLETED
Energy		Insect Study
Environmental		Landscape Architecture
Science
Fish and Wildlife		Mammal Study
Management
Forestry		Nature
Public Health		Nuclear Science
Soil and Water		Oceanography
Conservation
Bird Study		Plant Science
Fishing		Pulp and Paper
Fly-Fishing		Reptile and
		Amphibian Study
Gardening		Weather
Geology

Venturer:

After completing your conservation service project, complete the following requirements, document them on a separate sheet of paper, and attach them to the application.

1.Make a tabletop display or presentation on your conservation project for your crew, a Cub Scout pack or Boy Scout troop, or another group.

2.Lead a Cub Scout pack or another youth group in carrying out an age-appropriate conservation project from the list of Hornaday award categories.

Applicant:

I have completed the (check one): ■ Boy Scout ■ Venturer requirements listed above and I am applying for the WilliamT. Hornaday badge.

Applicant’s signature _________________________________________________ Date ______________________

Unit Leader:

I have reviewed this application and the requirements for the William T. Hornaday badge. The above requirements have been met, and the dates indicated accurately reflect our unit’s advancement records.

Unit leader’s signature ________________________________________________ Date ______________________

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B A D G E

Project Description for the

William T. Hornaday Badge

For your project, attach an executive summary, complete project description, and any supporting materi- als to this application. You may follow the structure that is identified in the Eagle Scout Leadership Service Project Workbook, No. 512-927, to help you record the plans and execution of the project. Be sure to identify the conservation issue or problem that your project was designed to address as well as any relationship that your project may have to other projects worked on by you or others. Individual work items cannot be counted in more than one project.

Applicants for the Hornaday badge must plan, lead, and carry out at least one project from an approved conservation category. For a list of approved categories and additional information, please see the official William T. Hornaday Award website at www.scouting.org/scoutsource/awards/hornadayawards.

The project is to be equivalent in scope to an Eagle Scout leadership service project. You may use your Eagle Scout project as a Hornaday badge project if it meets the aims and objectives of the William T. Hornaday Award. As such, the project must benefit a school, community, religious organization, or BSA property, or fulfill some other public service purpose. Applicants are encouraged to involve their unit members in project work and demonstrate Scout leadership, thereby making their unit eligible for

the unit award.

The project must contribute to sound conservation and environmental improvement in the local com- munity, the region, or the nation. The applicant is expected to research potential projects and to choose, with guidance from a Hornaday adviser, a worthy project.

There must be clear written evidence in your application that you did indeed plan, lead, and carry out a long-term, substantial project in one of the conservation categories. Additional written supporting material relating to the applicant’s conservation work (newspaper articles, letters of commendation, or photos of the completed project) will be considered. Evidence of leadership in researching, planning, leading, and carrying out the project, and of how this influenced other people, must be clearly documented.

Project

Project category __________________________________________________________________________________

Project title ______________________________________________________________________________________

Principal adviser to this project if other than the conservation adviser:

Name ___________________________________________________________________________________________

Telephone No. _____________________________

Date project completed __________________

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Endorsements and Actions for the

William T. Hornaday Badge

Applicant’s name ___________________________________________________

Conservation Adviser’s Approval

I have worked closely with the applicant named above in the design and execution of the required project. I have reviewed this application and recommend that the applicant receive the William T. Hornaday badge.

Adviser’s signature ___________________________________________________ Date ______________________

Unit leader’s signature ________________________________________________ Date ______________________

Council Conservation Committee’s Approval

The council conservation committee has reviewed this application, interviewed the applicant,* and determined that the applicant demonstrated leadership in the design and execution of the project described. The applicant has met all requirements for the William T. Hornaday badge and has this committee’s approval and endorsement.

Chair’s signature _____________________________________________________ Date ______________________

Scout Executive’s Approval

I have reviewed this application and approve the awarding of the William T. Hornaday badge to this applicant.

Scout executive’s signature ___________________________________________ Date ______________________

Note to local council: Following council approval, forward the completed application to:

Director of Conservation

Boy Scouts of America, S250

1325 West Walnut Hill Lane

P.O. Box 152079

Irving,TX 75015-2079

The certificate and badge will be returned to the council.

*For reasons of distance or geography, an ad hoc committee in the applicant’s community
may be designated for the interview.	2011 Boy Scouts of America

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