Big Brothers Big Sisters + Girl Scouts Membership Registration Form

Big Brothers Big Sisters + Girl Scouts Membership Registration Form
Complete the information below if you are interested in becoming a Girl Scouts volunteer as a Juliette mentor. You can also sign up your "Little" to be registered as a Juliette Girl Scout. Once the form is submitted, the registration information captured will be used to process your membership(s). Once processing is complete you will recieve a confirmation email to begin onboarding for you volunteer role.
Mentor Name *

First Name Last Name
Mentor Home Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Mentor Email *
example@example.com
Mentor Phone Number *

Area Code Phone Number
Mentor Gender *
Mentor Birth Date *

Month Day Year
Mentor Ethnicity *
Mentor Race *

American Indian or Alaskan Native Asian Black or African American Hawaiian or Pacific Islander White I choose not to share
Is your "little" already registered with a Girl Scout troop? *

Yes No I am unsure
Girl's Grade as of Fall 2021 *
Girl Name *

First Name Last Name
Girl Ethnicity *
Girl Race *

American Indian or Alaskan Native Asian Black or African American Hawaiian or Pacific Islander White I choose not to share
Girl Birth Date *

Month Day Year
School Attending *
Caregiver Name *

First Name Last Name
Caregiver Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Caregiver Ethnicity *
Caregiver Race *

American Indian or Alaskan Native Asian Black or African American Hawaiian or Pacific Islander White I choose not to share
Caregiver Birth Date (Enter 1/1/1900 if unsure) *

Month Day Year
Caregiver Phone Number *

Area Code Phone Number
Caregiver Email *
example@example.com
Welcome/Starter Kits
Each new mentor will have the opportunity to order a Welcome/Starter Kit for their "Little" with the option to have the kit delivered or picked-up at one of our two available Girl Scouts River Valleys Service Centers. All kits will include:
- Girl Scout sash or vest (girl choice). See size chart .
- All insignia for sash or vest
- Girl Scout Handbook for program grade level
- Girl Scout Memory book.
Would you like to order a Welcome/Starter Kit for your "Little"? *

Yes No
Please select the Sash or Vest option. *

Sash Vest
Select your "little" Program Grade Level *

Daisy (K-1) Brownie (2-3) Junior (4-5) Cadette (6-8) Senior (9-10) Ambassador (11-12)
Select Daisy - Junior size (K - 5th Grade). *

Small Medium Large X-Large Plus Small Plus Medium Plus Large Plus XL
Select Cadette - Ambassador size (6th - 12th Grade). *

Small Medium Large X-Large 1X 2X 3X
For pick-up or delivery? *

Pick-up at Brooklyn Center or Saint Paul Service Center Delivered directly (no shipping fee)
Select the preferred pick-up location. *

Brooklyn Park Service Center Saint Paul Service Center
Select the preferred direct delivery address. *

Mentor Home Address Caregiver Home Address
Should be Empty:

Big Brothers Big Sisters + Girl Scouts Membership Registration Form

Welcome/Starter Kits