Girl Member Training Registration
This form is to be used as a temporary mechanism to register for on-demand courses offered through Girl Scouts of Southern Arizona for girl members. A unique email should be used so a duplicate record of the caregiver is not created. Do not use a school-based email address as their firewalls view the emails as spam. *Please allow at least one business day for credentials to be issued.
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Troop Number or Juliette Number
*
Today's Date
*
-
Month
-
Day
Year
Date
You are requesting credentials to be issued for the following training:
*
Gold Award Training
Silver Award Training
By checking below I'm indicating I understand the login I'm providing for training is a unique email specific to myself. The username/login credentials for training provided by this registration is my email address and the training platform only allows email address to be used by a single user.
*
Yes, I understand
Submit
Should be Empty: