Leader Information Form

Please enter information about your troop for the 2010-2011 year

Troop Number

Troop Level

Grade

School

Number of Girls

Location, Day and Time
of meeting

Please enter information about yourself

First Name

Last Name

Position

Address

City

State

Zip Code

Home Phone

Work Phone

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:

Comments:

Last updated 6/23/2010