Girl Scouts, San Diego - Imperial Council
Change of Address/Membership Information
Instructions:
To the
best of your ability
, complete the first section with your initial registration information.
Type and NEW information in the second section.
Click on "Submit" when all pertinent information has been provided.
SECTION ONE: Member information as stated on initial registration form
*Full Name:
*First
:
*Middle:
*Last:
*Address:
Apt. #
*City:
*State:
*Zip:
*Phone:
Day
(
)
Evening
(
)
Email:
Service Unit:
GSUSA ID:
*Member Type:
Girl
Adult
If member type is GIRL:
Birthdate:
mm/dd/yyyy
Grade:
K
1
2
3
4
5
6
7
8
9
10
11
12
School:
Troop/Group #:
Independent:
By Choice
Awaiting Troop Placement
Not Applicable
If member type is ADULT:
Position Code:
Addt'l Position:
Troop/Group #:
Select previously report: (optional)
Racial/ethnic:
American Indian
Asian/Pacific Islander
Black
White
Other
Hispanic origin:
Yes
No
If transferring from another council
, please provide the council's name:
SECTION TWO: New Information (fill in all that apply)
New Name:
First:
Middle:
Last:
New Address:
Apt. #
City:
State:
Zip:
New Phone:
Day
(
)
Evening
(
)
New Email:
New Grade:
K
1
2
3
4
5
6
7
8
9
10
11
12
New School:
New Trp/Grp #:
Independent:
By Choice
Awaiting Troop Placement
Not Applicable
New Service Unit:
Change is for:
Self
Those listed
(please use full names)
Your comments and suggestions are welcome at any time. Please address to
webmaster@girlscoutssdi.org
.