Registration Form - Program Aide

Registration Form - Program Aides

Fayette Jessamine Girl Scout Day Camp - Session 2
Deadline to apply - May 1
I am under 18 years old

YesNo
PA Name

First NameLast Name
Your Camp Name
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
PA Phone Number
Please enter a valid phone number.
PA Email
example@example.com
Parent Name

First NameLast Name
Parent Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
I am currently registered as a
Troop Number
Numbers Only
Grade Completed in June
Birthdate

MonthDayYear
Is this your first year as a PA at Day Camp?

YesNo
Number of Years
Have you had Day Camp Training?

YesNo
Date of last Day Camp training?
Check all types of camping experience you have

Day CampTroop CampingResident CampFamily CampingOther (list below)
Briefly tell us about your experiences as a Program Aide in any capacity. Include age levels and any special kudos you have received.
I would prefer to work with the following level. (This is not a guaranteed placement.)

DaisyBrownieFly-UPJuniorPixiesBoysNo Preference
Program Aide T-Shirt Order Form
If unsure of size, order one size up. NO EXCHANGES.

Registration Form - Program Aides