Registration Fee Financial Assistance
Contact Details
Scout Name
*
First Name
Last Name
Parent Name
*
First Name
Last Name
Phone Number
*
Email
*
example@example.com
Unit Type and Number (e.g. Pack 123)
*
Number of Youth in the Household
*
Total Annual Household Income
*
Please Indicate the Council Fundraisers Your Unit Participates In
*
Popcorn
Camp Cards
Meat Sticks
None of the Above
Select Amount of Financial Assistance Requested
*
$25
$50
$75
Please Indicate the Reason for Financial Assistance
*
Submit
Should be Empty: