Trail of Tears Fifth-Grade Webelos Only

Return this completed list to your Unit Commissioner or District Executive before the October Roundtable.

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Webelos Graduation Date:__________________  Pack # _______ Webelos Den#/Patrol Name _____________ Date ______________

[ ] Our Pack has NO fifth-grade Webelos.          Our Pack has _____ fifth-grade Webelos.

Cubmaster ___________________________________ Phone #_____________________ Email ________________________________________

 

Webelos Leader

Name___________________________________

Address ________________________________

City_____________________ ZIP____________

Home Phone __________________________

Work Phone __________________________

Email __________________________________

 

Please Print           To Avoid Delaying Processing

Assistant Webelos Leader

Name____________________________________

Address _________________________________

City_____________________ ZIP_____________

Home Phone____________________________

Work Phone____________________________

Email ___________________________________

 

Webelos Name

Address

City

ZIP

Phone#

Birth Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[ ] If your den is larger than 10 check here and list on the back.