Mentored Troop - Membership Form

Mentored Troop - Girl Membership Form
Girl Name*

First NameLast Name
Troop number*
Girl Date of birth*

MonthDayYear
Current School Grade*
Name of school that girl attends: (no abbreviations, please)*
Girl Ethnicity*
Girl Race*
Caregiver Name*

First NameLast Name
Relationship with Girl:*
Caregiver Date of Birth*

MonthDayYear
Caregiver Ethnicity*
Caregiver Race*
Caregiver Gender*

MaleFemaleI Choose Not To Share
Were you (caregiver) ever a Girl Scout? Daisy, Brownie, or higher, it all counts!*

YesNoUnsure
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
County
Email*
Phone Number*

Area CodePhone Number
Staff Completing Form
Are you interested in ways to help?*

I'm ready to become a volunteer now - sign me up today!Please don't register me yet, but I would love to learn more about becoming a volunteer. Please contact me to discuss options and possibility of registeringUnfortunately I am not interested in volunteering
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Mentored Troop - Girl Membership Form