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PLEASE PROVIDE US WITH THE INFORMATION BELOW, AND WE WILL CONTACT YOU WITH INFORMATION ABOUT POTENTIAL TROOP OPENINGS IN YOUR AREA.

PARENT'S INFORMATION (*required fields)

FIRST NAME*		LAST NAME*

HOME ADDRESS*

CITY*

STATE*		ZIP*

DAYTIME PHONE*

EVENING PHONE*

EMAIL*

LIST THE THREE SCHOOLS NEAREST YOU:

GIRL'S INFORMATION:

FIRST NAME*		LAST NAME*		AGE*

FIRST NAME*		LAST NAME*		AGE*

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Girl Scout Council of Orange County | 9500 Toledo Way Irvine, CA 92618. General Line: (949) 461-8800 | Toll Free: (800) 979-9444