Training Registration - old outdated form

If you have reached this page, please click the link here to get to the new updated online training registration form.

All information must be completed to process.

Course #: Course Title: Course Dates: Times:

First Name:

Last Name: S.U. #:
Adult Position: Troop #: Section:
Mailing Address:  
City: Zip:
Home Phone #: Work Phone#: Email Address:

Are you a registered member of Girl Scouts of the USA? Yes No

Prog. Age Level: D BR JR CAD SR Other

Name of person conducting your Volunteer Orientation:

Name of person conducting your Leaders Resource Manual conference OR Volunteer Job Orientation Conference:

Race/Ethnic Information: (This information is used to monitor progress toward ethnic parity.)
White African Am. Asian/Pacific Isl. Am. Indian/Alask. Native Other Of Hispanic Origin

Special Accommodations: If you require special accommodations due to a disability, please indicate:

For Trainers Only: Hours Completed
Modules Completed: I II III
Did not attend:
Co-Trainer:

Phone: (504) 733-8220