2018-19 66th Confluence BPSA Rover/Adult Volunteer Registration
Group Scoutmaster: Colin Suchland
Rover Scout Leader: Jeff MacDonald
Group Auxiliary Chair: Jeff Kopp
66th Confluence Scout Group, St. Louis, Missouri
Baden-Powell Service Association, US (BPSA-US.org)
Contact us at (314) 669-5766 or 66thconfluence@gmail.com
Group info and calendar available at www.66confluence.org

Please complete this form for EACH Rover, Scouter (section leader) or Parent Volunteer registering.

Email address *
Name (First & Last) *
Your answer
Street Address *
Your answer
City, State, Zip *
Your answer
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Phone Number *
Your answer
What role would you like to undertake in our group? *
Social Security Number (required for Rovers, Scouters, and PVs only, not Aux. members):
Your answer
BPSA National & Group Dues
$20 BPSA-US Registration + $35 66th Confluence Group Dues = $55 per year.
(Charge for Parent Volunteers is only $20/year for BPSA-US)
Payment can be made by Cash, Check, or Money Order made payable to 66th Confluence BPSA, or thru PayPal to 66thconfluence@gmail.com.
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