GSMW Robotics Interest Form

Team Coach / Mentor

If you are selected to be a coach/mentor for a team, GSMW will submit each coach and team to FIRST® LEGO League. All coaches/mentors will be asked to complete a consent and release form.

All teams MUST have two Lead Coach/Mentors. All coaches/mentors will need to register as a member with Girl Scouts of Montana and Wyoming as well as complete a background check through GSMW prior to your first team meeting.
Name*

First NameLast Name
Gender - Per Girl Scout safety guidelines, a female adult must be in attendance at all times if male coaches are working with girls.*

FemaleMale
Mailing Address*

Street Address

Street Address Line 2

CityState

Zip Code
County*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Have you previously been a Coach / Mentor of an FLL team?*

YesNo
If YES, please explain further by giving us the year, team name, and age level.
STEM Experience - Please list any STEM (Science, Technology, Engineering and Math) experience. All skill levels are welcome, but is very beneficial for the FIRST® LEGO League teams that will be competing to have a Coach and/or Mentor with a strong interest in STEM. *

Team Volunteer

If coaches are male, please be aware that at least one female volunteer will need to be in attendance during meetings and competitions. All Team Volunteers will need to register as a member with Girl Scouts of Montana and Wyoming as well as complete a background check prior to your first meeting.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
County*
Volunteer Reason*

Parent of interested girlCommunity professional wanting to help mentor a teamYouth mentor (under age 18) with previous FIRST LEGO League experience
STEM Experience - Please list any STEM (Science, Technology, Engineering and Math) experience. All skill levels are welcome, but it is preferred to have volunteers that have a strong interest in STEM. *

Individual Girl

We are excited that you interested in FIRST® LEGO League!

Please be aware that NOT ALL TOWNS WILL HAVE A TEAM, but we will do our best to find a team in your area if there is one available next season.
Name*

First NameLast Name
Age in Fall*
Grade in Fall*
School in Fall*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
County*
Has she previously been part of an FLL team?*

YesNo
If your answer is YES, please explain further by giving us the year, team name, and age level.
Is she registered as a current Girl Scout?*

YesNo
Troop Information - If your girl is already part of a Girl Scout Troop, please list the Troop Number and Troop Leader.

Please provide any additional information that would be beneficial for GSMW to consider during our selection process for teams and coaches.
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