Boy and Girl Scout NASA Recognition Request Application
Boy Scout and Girl Scout Recognition Program

To ensure the Congratulatory Letter and Certificate of Recognition are prepared in proper format, please use initial capitalization for the first letter of the First Name, Middle Initial, Last Name, and Street and City.

A parent, troop leader, or legal guardian can make a request on behalf of a scout who has achieved the rank of Eagle Scout or Gold Awardee. The Congratulatory Letter and Certificate of Recognition will be mailed to the address listed below - this can be the address of a parent, troop leader, or legal guardian if you do not want the scout to receive the certificate and letter directly.

Request Form
Fields with * are required.

Name of Scout*
*Recipient must be at least 13 years of age
Mr.* Ms. *
Example: John

Example: A
Example: Smith
Address to which the Congratulatory Letter and Certificate of Recognition will be mailed:
Example: 135 Potomac Drive or 234 DuVall Street
Example: Springfield
Contact Information of Requester:*

*This information is requested in order to allow for verification of the above information to ensure the certificate and letter are printed accurately.

Example: (123)456-7890 or 123-456-7890

By submitting this request, I am acknowledging that the designated scout:

- has achieved the level of Eagle Scout or Gold Award,

- is 13 years or older, and

- I am the parent, legal guardian, or troop leader of the designated scout.

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