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Please fill out the form below to enroll:
CONTACT INFORMATION
First Name:
Last Name:
Street Address:
City:
State:
Zip:
Phone Number:
Phone Type:
Cell
Home
Work
Best Time to Call:
Day
Evening
E-mail Address:
Relationship to Girl:
How did you hear about Girl Scouts:
Democrat & Chronicle
Local Paper
Genesee Valley Parent Magazine
Town Website
Family
Internet
Friend
School
Radio
TV
Lawn Sign
Relative of a Girl Scout
I was a Girl Scout
Other
GIRL INFORMATION
First Name:
Last Name:
Street Address:
City:
State:
Zip:
Grade in Fall:
School District:
- Please Select -
Albion Central Schools (O)
Alexander Central Schools (G)
Attica Central Schools (W)
Avon Central Schools (L)
Batavia City Schools (G)
Brighton Central Schools (M)
Brockport Central Schools (M)
Byron-Bergen Central Schools (G)
Caledonia-Mumford Central Schools (L)
Churchville-Chili Central Schools (M)
Dalton-Nunda (Keshequa) Central Schools (L)
Dansville Central School (L)
East Irondequoit Central Schools (M)
East Rochester Central Schools (M)
Elba Central Schools (G)
Fairport Central Schools (M)
Gates Chili Central Schools (M)
Geneseo Central Schools (L)
Greece Central Schools (M)
Hilton Central Schools (M)
Holley Central School (O)
Honeoye Falls-Lima Central Schools (M)
Kendall Central Schools (O)
LeRoy Central Schools (G)
Letchworth Central Schools (W)
Livonia Central Schools (L)
Lyndonville Central Schools (O)
Medina Central Schools (O)
Mt Morris Central Schools (L)
Oakfield-Alabama Central Schools (G)
Pavilion Central Schools (G)
Pembroke Central Schools (G)
Penfield Central Schools (M)
Perry Central Schools (W)
Pittsford Central Schools (M)
Rochester City Schools (M)
Rush-Henrietta Central Schools (M)
Spencerport Central Schools (M)
Warsaw Central Schools (W)
Webster Central Schools (M)
West Irondequoit Central Schools (M)
Wheatland-Chili Central Schools (M)
Wyoming Central Schools (W)
York Central Schools (L)
School Name:
- Please Select School District -
If she attends a Rochester City School and does not attend the school that is closest to her home, what is the closest school to her home?:
Parent/Guardian Name (if different than contact):
Email address (if different than contact):
Has she ever been a Girl Scout before?:
No
Yes
Is she interested in joining a Girl Scout troop or is she interested in participating as an independent (we call them Juliettes)?:
Troop
Juliette
Either
Please add any additional information that may help us get your daughter involved in Girl Scouts: (ex: my daughter has violin lessons on Tuesday it would not be a good meeting night, my daughter and I want to be in Troop # XYZ as we have friends there; my daughter will require special accommodations...):
ADULT VOLUNTEER INFORMATION
If you are interested in volunteering your time with Girl Scouting, please help us by answering the following questions:
I am interested in:
N/A
Leading a troop
Training volunteers
Planning events
Assisting with programs
Coordinating volunteers
Helping to recruit girls
I'm not sure. I need additional information.
I have the following special skills or interests:
Please tell us any additional information that might help us find the perfect place for you in Girl Scouting: