Know Your Normal: Pilot Sign Up Form
We’re excited to open our Know Your Normal breast health pilot program to a limited number of Girl Scout troops. If selected, your feedback will help shape the future of this program, ensuring that it continues to serve youth with meaningful, age-appropriate, and empowering tools for self-awareness. Even if your troop isn’t selected for the pilot, all interested leaders will be notified when the official Know Your Normal Patch Program launches. Any scouting or youth-serving group will be invited to participate at that time.
Contact Information
First/Last Name
Troop Number or Group Name
Email
example@example.com
Mailing Address (for program materials)
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Phone Number
Please enter a valid phone number.
Age Range of Participants
under 10
10-11
12-13
14-15
16-18
Grade Level Represented
Below 5th
5th
6th
7th
8th
9th
10th
11th
12th
Total Number of Youth Participants
Can you commit to using the pilot program materials with your troop by November 30, 2025?
Yes
No
Do you agree to submit an evaluation form after facilitating the pilot program?
Yes
No
Submit
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