Queen's Badge Application

Please complete the form below to process an application for Queen's Badges.

The form can be used to process applications for multiple young people (upto 4) in a single transaction, additional fields will appear as you add individual applicants.

Company Name: *

Region *

District/Area *

Battalion *

Leader Details

The details entered below will be used to dispatch the awards.

First Name *

Last Name *

Position/Role *

Address Line 1 *

Address Line 2

Town/City *

County *

Postal Code *

Phone Number *

Email Address *

Applicant's Details

Applicant 1

Young Person's Name *

Completed Through: *

Queen's Badge Completion Attended (Date & Organiser) *

Current Service Badge *

Address (inc Town, County, Postcode) *

Date of Birth * +

Email Address

Applicant 2

Young Person's Name (2)

Completed Through: *

Queen's Badge Completion Attended (Date & Organiser) *

Current Service Badge *

Address (inc Town, County, Postcode) *

Date of Birth * +

Email Address

Applicant 3

Young Persons' Name (3)

Completed Through: *

Queen's Badge Completion Attended (Date & Organiser) *

Current Service Badge *

Address (inc Town, County, Postcode) *

Date of Birth * +

Email Address

Applicant 4

Young Persons' Name (4)

Completed Through: *

Queen's Badge Completion Attended (Date & Organiser) *

Current Service Badge *

Address (inc Town, County, Postcode) *

Date of Birth * +

Email Address

Applicant 5

Young Persons' Name (5)

Completed Through: *

Queen's Badge Completion Attended (Date & Organiser) *

Current Service Badge *

Address (inc Town, County, Postcode) *

Date of Birth * +

Email Address

Applicant 6

Young Persons' Name (6)

Completed Through: *

Queen's Badge Completion Attended (Date & Organiser) *

Current Service Badge *

Address (inc Town, County, Postcode) *

Date of Birth * +

Email Address

Applicant 7

Young Persons' Name (7)

Completed Through: *

Queen's Badge Completion Attended (Date & Organiser) *

Current Service Badge *

Address (inc Town, County, Postcode) *

Date of Birth * +

Email Address

Applicant 8

Young Persons' Name (8)

Completed Through: *

Queen's Badge Completion Attended (Date & Organiser) *

Current Service Badge *

Address (inc Town, County, Postcode) *

Date of Birth * +

Email Address

Authorisation of Awards

I confirm that the above applicant(s) have: *

Participated in a Queen's Badge Completion Course

Been an Active Member of the Company for last 12 months

Been recommended by Company Captain

Completed all other requirements for Queen's Badge

Awards have been approved by Battalion/District (as required)

Award(s) have been approved by Queen's Badge Coordinator/Advisor (as required) *

Yes

No (provide reason below)

Coordinator/Advisor Name *

Battalion/District *

Date Approved * +

Reason award has NOT been approved by Coordinator/Advisor (i.e. Not currently a QB Advisor in Battalion/District) *

Date of Presentation (if known): +

Awards & Payment

Enter quantities for the items you would like to order for the above applicants (based on 1 per applicant): *

Queen's Badge & Certificate - £14.50

Please note:

- Minatures are now included as standard for all applicants.

- Total number of awards MUST not exceed number of participants listed above.

Payment Total:

£0.00

PLEASE ENSURE YOU COMPLETE THE PAYMENT PROCESS FULLY - You will see an on screen order confirmation and receive an email confirmation once your order has been completed succesfully. if you do not then it is likely you have not fully completed the payment process.