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Boy Scouts Third-Party Witness Statements

Claimant Connection to Scouting

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* = required

1 Boy Scout Claimant Name

Name of person who was in Scouting:

First Name * Example: John

Last Name * Example: Smith

SST Number (if known) Example: 57856

2 Relationship to Claimant

My relationship to the Boy Scout Claimant was/is:
Parent
Sibling
Neighbor
Scoutmaster/Assistant Scoutmaster
Volunteer with Scouting
Fellow Scout
Classmate
Teacher
Friend
Other (please explain if other)

Check All That Apply

3 Claimants Connection to Scouting

I know the above person / Boy Scout Claimant was connected to Scouting because I was a:
Scoutmaster/Assistant Scoutmaster / Volunteer
Fellow Scout in same troop
Fellow Scout in another troop
Classmate who knew the Claimant was in Boy Scouts
Friend who knew the Claimant was in Scouts
Saw the Claimant in a Boy Scout uniform
Sibling who knew my Brother was in Boy Scouts
Parent who knew my son was in Boy Scouts
Other

Check All That Apply

4 Your Information

Please provide your contact information in case further information is needed:

First Name * Example: John

Last Name * Example: Smith

Address * Example: 1234 Somewhere Ave.

City * Example: Houston

State * Example: Texas

Zip Code * Example: 77002

Phone * Example: 5555551234

E-Mail * Example: someone@someplace.com