Wood Badge Participant Personal Resource Questionnaire


1.  First Name:  Middle Name:  Middle Initial:  Last Name:  Title:

   I would like to be called:  T-Shirt size:


2.  Address:City:State:ZIP:


3.  Phone (H): Phone (W): Phone (Cell): FAX:


4.  Occupation:email:email2:


5.  Date of Birth: (mm/dd/yyyy):District:Unit No.:Type:


6.  Council name:Council No.:


7.  Years in Scouting; Adult:   Boy:Rank:


8.  Current registered position:(List only your primary position)


8a.  Unit Position, if not Primary:


9. Adult positions held, and how long?

     How Long    How Long
   Scoutmaster:        Assistant Cubmaster:      
   Assistant Scoutmaster:        Den Leader:      
   Unit Committee Chairman:        WEBELOS Den Leader:      
   Unit Committee Member:       Varsity Coach      
   Unit Commissioner:       Assistant Varsity Coach:      
   Cub Scout Roundtable:        Venturing Leader:      
   Boy Scout Roundtable:        Assistant Venturing Leader:      
  Council Committee          
  Council Board        Other Positions Held:
   A D C:            
   District Commissioner            


10. Scouting Awards Received:      District Award of Merit:   Silver Beaver:   Eagle:  Adult Religious Award:




11. Physical Condition:


12. Camping Experience:


13. Training Experience: When Completed:?

  Yes/No  Date Other Training Experiences  Date

 Leader Specific:

 Introduction to Outdoor Leader Skills:

 Youth Protection Training:


 WEBELOS Leader Outdoor:


14. State why you decided to participate and what you expect to gain from this experience:


15. Religious Preference:


16. First Aid Training; Red Cross Advance:    CPR:    EMT:   Other:


17. Spouse: Emergency Contact 1: Emergency Phone 1:
                                                             Emergency Contact 2: Emergency Phone 2:



Participant PRQ (BTC)
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Revised: 2018/03/21