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Girl Scout Interest Form

After completing the information below you will be contacted by a Girl Scouts staff member. Any girl who is between five and 17 years old can become a Girl Scout by accepting the Girl Scout Promise and Law and paying the $10 membership dues.

Please fill out the form below. All fields marked with an asterisk (*) are required.

General Information:
Girl's Name*:

Age*:
Grade*:
Girls School*:
Nearest Public School*:

Parent/Adult's Name*:

Contact Information:

Address*:

City*:

State*:

Zip*:
Email Address*:

Home Phone*:

Work Phone:

Additional Information:
Additional information, comments, or questions:



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Farthest North Girl Scout Council, Inc. • T: 907.456.4782 • F: 907.452.2320 • E: info@fairbanksgirlscouts.org
Toll Free: (800) 478.4782 (within Alaska only)

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