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Girl Membership Interest Form

We're glad you are interested in joining Girl Scouts! Please complete this form and click on the submit button at the bottom of this form. Please note that girls will be placed in troops near their own neighborhoods or schools depending upon the availability of volunteer leadership. Placement is handled in local areas by our volunteers. A volunteer or staff Membership Manager will contact you once your girl is placed.


Please indicate if you are interested in:

Troop Placement

  

As an Individual

Tell Us About You

Girl's First Name

  

Date of Birth

Grade
 

Girl's Middle Name

  

Name of School Attending
 

Girl's Last Name

  

Neighborhood Public Elementary School
 

School District Name

  

School District County
 

Parent/Guardian First Name

  

Daytime Telephone
 

Parent/Guardian Middle Name

  

Evening Telephone
 

Parent/Guardian Last Name

  

Best Time to Reach Parent/Guardian
 

Mailing Address

  

City
 

State

Zipcode

  

E-mail Address
 
 

Tell Us How You Heard About Girl Scouts

Friend

Web

  

Brochure

Yard Sign

Bus Ad

Flyer

  

Subway Ad

Other: 

 

Check All That Apply

We have re-located from another Girl Scout Council

Name of Council

Current Troop Number
 

Reason For Transfer Request
 

If You Are Interested in Helping With Your Girl's Troop, Please Select From the Following

Lead or Co-Lead

  

Assist a Leader

I would like to help with troop activities

    
 

Comments or Questions

If you are interested in volunteering as an adult, please read and sign the agreement below:

I understand that I will need to become a registered member of Girl Scouting ($12 fee) and that a background check will be done using my Date of Birth and Social Security Number. This information will be kept confidential. After submitting this form, I understand a staff Membership Manager or Volunteer Service Team Member will be in contact with me.


Please enter your name in the box below for agreement: