ProtoCharter Application
This form is used to begin the Chartering process. Please fill it out in full. Our New Charters Coordinator will contact you within one week.
SSI Website User Name *
Please list the User Name you would like for us to use to create your website account. This is your personal username that you will use to log in on the website and the Moodle training site. This can be as simple as your first initial and last name. It does not represent your Circle or Hearth. User Name must have no spaces, capitals or special characters.
Your answer
Email Address *
Please be sure to use an email address that you access regularly. This email address will be used for all SpiralScouts communication and information, as well as your personal “membership” in our PC Google Group. Requests to change email addresses cannot be accommodated.
Your answer
Legal Name *
Your answer
Mailing Address *
Your answer
City *
Your answer
State/Province *
Please type the full state/province name. Do not use short forms.
Your answer
Zip/Postal Code *
Your answer
City - Charter
List the city the Charter will be located in if different from Mailing Address
Your answer
Contact Phone Number *
Your answer
Will this be a Military Charter? *
ProtoCharter Type *
Hearth - Single Family Charter / Circle - Multiple Family Charter
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