Community Delegate Submission Form

Community Delegate Submission Form
Once your community (service unit) elects its delegate(s) and alternate delegate(s), each elected individual (youth and adult delegates) must submit this form. The delegate/alternate term corresponds with the membership year which is October 1-September 30.
Delegate Community (Service Unit)*
To look up your community name or number, see our Community/Area Roster.
Elected as*

DelegateAlternate
I am registered as*

AdultYouth member (must be 14 years old by October 1, 2025)
Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
By providing my email and phone number, I give Girl Scouts River Valleys consent to provide notice to Voting Members by a form of electronic communication such as email or phone.*

YesNo
Should be Empty: