Child's Last Name:

Child's First Name: MI

Address Apt No.

City State Zip Code

Phone Number: Best Time to Call:

Mother Last Name: Mother First Name:

Mother Work Number

Father Last Name: Father First Name:

Father Work No.

E-Mail Address:

Child's School :

Grade for 2000-2001:

When would be good for your daughter to attend weekly scout meetings? Monday evening Tuesday evening Wednesday evening Thursday evening Friday evening Saturday day Saturday evening Sunday day Sunday evening

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As a mom or dad, I would like to help with the troop in the following ways:

As needed Donations Emergency Mom Help with events Phone mom Snack Coordinator Transportation Other (please list) Not interested Other:

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