Interest Indicator Form

Joining Girl Scouts is simple. Just complete the form below and you’ll be contacted by one of our local staff members, who can tell you about the options in your area.

COPPA Permission Statement: The Children’s Online Privacy Act (COPPA) requires the operator of any website or online service that collects children’s personal information to obtain verifiable parental consent for the collection, use, or disclosure of such personal information. The form below must be completed by a parent/guardian. The contact information provided will be used for communication and membership initiatives only. It will not be sold or distributed to outside vendors for any reason. By checking this box, I certify that I am the legal parent/guardian of the child(ren) listed below and that I have read the COPPA permission statement above.
Parent/Guardian Name:	Town You Live In :
E-mail Address: *required	Confirm E-mail Address:
Phone:
Preferred Contact Method: E-mail Phone
I am interested in volunteering.
Please complete the following information for any children you have who are interested in becoming Girl Scouts:
Girl's Name (1):	Grade Level:	School Name:
Girl's Name (2):	Grade Level:	School Name:
Girl's Name (3):	Grade Level:	School Name:
Girl's Name (4):	Grade Level:	School Name: