Girl Scouts

Please fill out the form below to enroll:

CONTACT INFORMATION
First Name:
Last Name:
Street Address:
City:
State:
Zip:
Phone Number:
Phone Type:
Best Time to Call:
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:
School Name:
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?:
Is she interested in joining a Girl Scout troop or is she interested in participating as an independent (we call them Juliettes)?:
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:
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: