Troop 212 Prospective Scouts
If interested in joining Boy Scout Troop 212 in Moraga, California, complete and submit this form. Candidate names are accepted in order and handled in accordance with the troop recruitment policy (http://www.bsa-troop212.org/join-troop-212). If you have multiple candidates in your family, submit a separate form for each.
Prospective Scout's First Name *
Enter the candidate's first name.
Your answer
Prospective Scout's Last Name *
Enter the candidate's last name.
Your answer
Mother's Name *
Enter the first and last name of the candidate's Mother.
Your answer
Mother's Email Address *
Enter the email address for the candidate's Mother.
Your answer
Mother's Phone Number *
Enter the phone number (xxx-xxx-xxxx) for the primary adult contact for this candidate.
Your answer
Father's Name *
Enter the first and last name of the candidate's Father.
Your answer
Father's Email Address *
Enter the email address for the candidate's Father.
Your answer
Father's Phone Number *
Enter the phone number (xxx-xxx-xxxx) for the primary adult contact for this candidate.
Your answer
Street Address *
Enter candidate's home street address.
Your answer
City *
Select candidate's home city.
Other City
If not listed in the previous field, type the candidate's home city.
Your answer
State *
Select candidate's home state.
Other State
If not listed in the previous field, type the candidate's U.S. Postal Service two-letter home state.
Your answer
ZIP Code *
Enter candidate's 5-digit home ZIP code.
Your answer
Date of Birth *
Select the candidate's Date Of Birth.
MM
/
DD
/
YYYY
Candidate's Current School *
Private or Other School
If you selected "private" or "other" for school, please type the name of the school in this field.
Your answer
Expected year of high school graduation *
Candidate's Current Grade in School *
Select candidate's current grade in school. Please do not complete this form prior to the 5th grade.
Relationship with Troop 212
Select all items applicable to the candidate.
Troop 212 Sibling(s) or other immediate family member(s)
Type the name of at least one sibling, father, grandfather, or other ancestors who are currently or were previously active in Troop 212 in support of your response to the "Relationship with Troop 212" question. Include first and last name. Separate each person with a comma.
Your answer
Cub Scout Pack Number
If candidate is currently a Cub Scout, enter the Pack number in this field.
Your answer
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