Pleasant Valley Pathfinder Club Membership Application
Please review the document information and then fill out the corresponding fields below. Please fill out the form as completely and accurately as possible (not just the required fields).
Pathfinder club being joined
*
Pleasant Valley
Pathfinder Signature:
*
Pathfinder Name
*
(Parent's) Email
*
example@example.com
Parent/Home Phone (Primary Phone Number)
*
Is the phone number you provided a home phone or a cell phone?
(Home)
(Cell)
Address
*
Address
Street Address Line 2
City
State
Zip
School
*
Grade
*
Church
I have been a Pathfinder before
Yes
No
(If applicable) I have been a Pathfinder before at:
Leave blank if does not applicable
My dad is a Master Guide
Yes
No
My mom is a Master Guide
Yes
No
My dad has been a Pathfinder
Yes
No
My mom has been a Pathfinder
Yes
No
Pathfinder's name
*
Applicant Birth Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Signature of father or guardian
Father's or guardian's occupation
Signature of mother or guardian
Mother's or guardian's occupation
Date of application
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Pathfinder Name
*
Age
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Pathfinder Signature
*
Pathfinder Name
*
Parent or Guardian's Signature
*
Date
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Preview PDF
Submit
Should be Empty: