IRM/Online Only Sign Up & Agreement

Welcome to the new Product Program year!

Please fill out the form below for your Girl Scout to be added as an IRM.

Prior to the product program, please complete the Troop Product Manager (TRPM) training as required by the Service Unit Product Manager (SUPM).
SU Number*
SU Product Manager Email*
example@example.com
Caregiver Name*

First NameLast Name
Caregiver Email*
example@example.com
Girl Scout Name*

Youth First NameYouth Last Name
Girl Scout Program Level*
If multiple Girl Scouts are participating under the same IRM number, indicate additional names and program levels here.
Caregiver Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Deposit slips will be sent by council to the address listed above.

Welcome to the new Product Program year!

Your Product Program Manager will reach to you regarding the next steps after receiving your submission.
Girl Scout Name*

Youth First NameYouth Last Name
Girl Scout Program Level*
If multiple Girl Scouts are participating as Online Only, please list their names and program levels
Caregiver Name*

First NameLast Name
Caregiver Email*
example@example.com
Office for product and reward pick up*

Bremerton (1600 NE Winters Rd, Bremerton, WA 98311)Everett (3224 Wetmore Ave A, Everett, WA 98201)Seattle (5601 6th Ave S, Ste 150, Seattle, WA 98108)Tacoma (5849 Tacoma Mall Blvd Suite D, Tacoma, WA 98409)
Do you have any questions we can answer for you?

Before submitting, please double check that all of the information submitted is correct. A copy of your answers will be automatically emailed to you.
Date

MonthDayYear
Date
Caregiver Name*

First NameLast Name
Should be Empty: