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Leader Information Form
Please enter information about your troop for the 2009-2010 year
Troop Number
Troop Level
Daisy
Brownie
Junior
Cadette
Senior
Ambassador
Grade
K
1
2
3
4
5
6
7
8
9
10
11
12
School
Buttonball
Eastbury
Hebron Avenue
Hopewell
Naubuc
Nayaug
Gideon Welles
Smith Middle
High School
Number of Girls
Location, Day and Time
of meeting
Please enter information about yourself
First Name
Last Name
Position
Leader
Co-Leader
Asst Leader
Cookie Mom
Helper
Service Unit Team member
Other
Address
City
State
Please choose:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other
Zip Code
Home Phone
Work Phone
Email
Years in scouts:
Girl:
Adult:
(count this year as 1 even if you just started)
Please check off if you have attended the training, entering in the year the training was received:
Training
First Aid, Year:
CPR, Year:
Please check off if you would like more information on:
Planning meetings
Songs
Service Project Ideas
Games
Paper work
Craft
Field trip planning
Ceremonies
Recruiting adult help
Other
Comments:
Last updated 12.7.2009