Once your group has completed the Appalachian Experience by hiking from Kittatinny Mountain Scout Reservation to Yards Creek Scout Reservation, or Yards Creek to KMSR please complete the form below and mail to AT Experience at 54 Ellmyer Road, Edison, New Jersey 08820 along with a check made out to Manny Coelho for $3 per person completing the hike. You will be mailed specially numbered patches commemorating your accomplishment.

Tour Leader-____________________________________________________________

Dates Of Hike-__________________________________________________________

Bsa Troop Number Or 
Organization Name_______________________________________________________

Address-________________________________________________________________

Town-___________________________________________________________________

State-__________________________ Zip Code-______________________________

Names Of Those Who Completing The At Experience:

1.__________________________________2.__________________________________

3.__________________________________4.__________________________________

5.__________________________________6.__________________________________

7.__________________________________8.__________________________________

9.__________________________________10._________________________________

11._________________________________12._________________________________

13._________________________________14._________________________________

15._________________________________16._________________________________

17._________________________________18._________________________________

19._________________________________20._________________________________

Amount Enclosed-___________________________  Check #____________________



To improve the Appalachian Trail experience,
 we are interested in your comments. Also, please 
let us know if there are any errors in the trail description.

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________