If you have gotten your eagle, and would like a Four Winds Ceremony, an indian ceremony that explains the values of an eagle, please fill out this form, and submit.

Please provide the following contact information:

*Eagle Scouts Full Name:

*Eagles Troop Number:

*Person to get in contact with

*Contact's Address

Contact's Address (cont.)

*Contact's City

*Contact's State

*Contact's Zip Code

*Contact's Home Phone (xxx) xxx-xxxx

*Contact's E-mail

Second Contact's Name

Second Contact's Street Address

Second Contact's Address (cont.)

Second Contact's City

Second Contact's State

Second Contact's Zip Code

Second Contact's Home Phone (xxx) xxx-xxxx

Second Contact's E-mail

*Weekday of Ceremony: *Date of Ceremony:

*Time of meeting:

*Location of Ceremony:

Time Ceremony Starts:

Time We Can Arrive:

Comments or other useful information:

North Star OA Chapter Thanks YOU for your interest!!!

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or Mark Wilbur

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