Agaming Maangogwan Lodge 804 Water and Woods FSC
ORDER OF THE ARROW ELECTION REPORT
Fill in all information requested.
Troop Number ______District______Date of Election______
Number of registered active youth members ______Number of youth members present at election: ______
Number of youth members eligible: ______Numbers of votes required to be elected: ______
Number of ballots turned in: ______Number of youths elected: ______
Check here
If elected: List all eligible Scouts. Incomplete or inaccurate information may delay notification to those elected.
Name: / Hm. Phone: / Cell Phone:Address / Rank: / Email:
City, State, Zip: / Birthday: / BSA ID #:
Name: / Hm. Phone: / Cell Phone:
Address / Rank: / Email:
City, State, Zip: / Birthday: / BSA ID #
Name: / Hm. Phone: / Cell Phone:
Address / Rank: / Email:
City, State, Zip: / Birthday: / BSA ID #
Name: / Hm. Phone: / Cell Phone:
Address / Rank: / Email:
City, State, Zip: / Birthday: / BSA ID #
Name: / Hm. Phone: / Cell Phone:
Address / Rank: / Email:
City, State, Zip: / Birthday: / BSA ID #
Name: / Hm. Phone: / Cell Phone:
Address / Rank: / Email:
City, State, Zip: / Birthday: / BSA ID #
I certify these scouts have: 1.) attained the rank of 1st Class; 2.) camped for 15 days/nights with a Boy Scout Troop during the last two years (5 nights consecutive); 3.) actively participated in unit events; 4.) shown Scout Spirit; 5.) approved for membership in the Order.
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Unit Leader’s Name Phone Number Unit Leader’s Signature
If an election was held for your unit and at least one scout was elected, the Troop may nominate one adult for the Order.
This adult must meet all of the same requirements as a youth eligible for election. (See above)
Name: / Hm. Phone / Cell Phone:Address: / Birthday: / Wk. Phone:
City, State, Zip: / Position: / Email:
# of Days and Nights of Camping in the last two years. / Lodge Term Camp Date: / BSA ID #
1. Years in Boy Scouting: ______
2. List past Scouting positions held: ______
3. List skills or abilities of this nominee that will help the Order provide service and promote camping: ______
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4. How will this nominee have a positive influence on the youth members and bring honor to the Order?
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Election Certification
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Troop Committee Representative Contact Phone Number OA Chapter Adviser
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Youth OA Troop Representative Youth Rep: Phone Number Election Team Certification - Name
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Adult OA Troop Representative Adult Rep: Phone Number Election Team Certification - Signature
Please note that all election results are final. No substitutions may be made for any reason.