Alumni Association Membership Application
Alumni Association Membership Application
*Name
First
*Last Name
*Address
*City, State Zip
*Phone
(Area Code First)
*Email
*Birth Date
MM/DD/YYYY
Gender
*Are you retired?
Profession:
(If applicable)
Business Address:
(If applicable) Address/City/State/Zip
Business Phone:
(If applicable)
As a youth, were you involved in?
(Check all that apply)









Where did you do your Scouting?
(State or if outside the USA, what country)
*What was the highest rank you achieved in Scouting?
How did you hear about us?
Who referred you? If not applicable, skip
*Are you currently involved in Scouting?
Please tell us your current involvement
(If applicable)
*Would you like to get reengaged in Scouting?
At what level would you like to reengage?
(check all that apply)






As we develop sub-chapters within our Alumni Association, please indicate your preferences for involvement (if any) in:
(Select all that apply)








*Would you be willing to help out with a service project?
*Do you have any special talents, assets, or work experience that could benefit Scouting that you would be willing to share?
If yes, please describe:
(If applicable)
Comments or suggestions: