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Please complete the form below for more information on volunteering with Girl Scouts of Ohio's Heartland or registering an adult or girl in Girl Scouting. Blank fields or incorrect information may delay someone contacting you.

NOTE: Fields with an asterisk (*) are required.
Date: *
Name: *
Address: *
City: *
Zip: *
County: *
Day Phone: * (xxx-xxx-xxxx)
Evening Phone: * (xxx-xxx-xxxx)
Fax:
Best time to call: *
Email:
I am interested in becoming an adult in Girl Scouting. Particularly interested in:
Working with adults:
Leader/Advisor/AssistantProgram Events Strategic PlanningFinance EducationPR/Fund Development Property MaintenanceProduct Sales Board of DirectorsOther
Working with girls in the following age levels:
Daisy (grades K-1)Cadette (grades 6-8) Brownie (grades 2-3)Senior (grades 9-10) Junior (grades 4-6)Ambassador (grades 11-12)
I am interested in volunteering:
one day a weekquarterly every other weekperiodically one day a monthother
I am interested in registering my daughter/ward in Girl Scouting.
Girls Name:
Age:
School grade:
School she attends/School district:
Nearest school to home:
Additional Information: