Member Record Change Form

Member Change Form
This form is to be used by leaders, parents and staff to request changes to member records. Use this form to submit troop transfers, volunteer position changes, school, grade and/or household changes.

** Transfer of inactive girls will not occur between April 1 and September 30 due to restrictions of the sytem*
Your Contact Information

(Person Completing Form)
Full Name*
First & Last
Email Address*
example@example.com
Confirm Email Address*
Type of Change*

Change in MembershipPersonal Information Change
Change in Membership
Full Name of Member:*
First Last
Member Status*

AdultGirlLifetime
Apply changes to Membership Year*

2023-20242024-2025
Type of Change*

Troop ChangeVolunteer Role Change
Current Troop#:*
New Troop#:*
If the member is no longer participating in Girl Scouts, put "Not Active"
Current Volunteer Role*
New Volunteer Role:*
Personal Information Change/Update
Full Name of Member*
Type of Change (Please Select All that Apply):*

NameAddressPhone NumberEmail AddressSchoolGradeDate of Birth
New Name:*
Former Address (Street, City, State, Zip Code):*
New Address (Street, City, State, Zip Code):*
Change to Phone Number(s):*

HomeMobileWorkOther
Former Home Number*
New Home Number*
Former Mobile Number*
New Mobile Number*
Former Work Number*
New Work Number*
Former Other Number*
New Other Number*
Former Email Address:*
New Email Address:*
New School Name*
Grade*

K1st2nd3rd4th5th6th7th8th9th10th11th12th
Reason for Change:*
Should be Empty:

Member Change Form