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Girl Scout Program Interest Form
Fill out the form below and we will connect with you within 72 hours to finalize the details of your event!
Contact Information
Name
*
First Name
Last Name
The person submitting this form:
*
Troop Leader
Girl Scout
Parent/Guardian
Phone
*
Email
*
Verify Email
*
Parent or Guardian Contact Info
Girl Scouts under 18 years of age must provide a parent or guardian's name and phone number here.
Girl Scout Level
*
select one
Daisies
Brownies
Juniors
Cadettes
Seniors
Ambassadors
Troop Number
Optional: Please enter your girl scout troop number
Badge Programming
Optional: Please select Monarch Tagging or the badge you are interested in completing with BCWA!
select one
Animal Habitats
Bugs
Citizen Science-Monarch Tagging
EcoTrekker
Flowers
Water
Other- Explain in Comments Box
Date/Time Interest
Optional: Please share if you desire weekday day, weekday evening, or weekend programming.
select one
Daytime (M-F) btw 9a-5p
Evening (M-F) btw 5p-8p
Weekend (Sa, Su) btw 10a-4p
Monarch Tagging Dates
Select the date you are interested in Monarch Tagging.
select one
Su 8/27/23 AM
Su 8/27/23 PM
Sa 9/9/23 AM
Sa 9/9/23 PM
Su 9/10/23 AM
Su 9/10/23 PM
Sa 9/23/23 AM
Sa 9/23/23 PM
Su 9/24/23 AM
Su 9/24/23 PM
Sa 9/30/23 AM
Su 10/1/23 AM
Su 10/1/23 PM
Other- Sept. Weekday Evening
Awards and Service Project Work
Optional: Let us know if you want to partner with BCWA to complete service hours or work on your Gold, Silver, or Bronze Award.
select one
Gold Award
Silver Award
Bronze Award
Service Hours
Comments/Questions
Do you have any additional comments/questions?
