Become a Girl Scout

Fill out the form below and a local Girl Scout representative will contact you on the next steps to becoming a Girl Scout of Kentuckiana!

* Denotes a required field

* Parent/Guardian Name:
FIRST  LAST 
*Girl Name:
FIRST  LAST 
Girl Name:
FIRST LAST
Address:
 
City/State/ZIP:
   
CITY   STATE   ZIP
Phone:
  (ex: 123-456-7890)
School Name:
  (if applicable)
*Grade:  
*Email:  
Pathway(s) I'd Like To Join:
(Hold Ctrl to select multiple)

Comments:
 
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