Mentored Troops: Girl E-Registration Parent Name First Last Email Address Phone NumberAddress Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Girl Name First Last Girl's GradeK123456789101112Girl's Birthdate MM slash DD slash YYYY Girl’s Race – Select as many as apply. Hold down the Ctrl (Cmd on Macs) key as you click to select multiple options.Am. Indian or Alaskan NativeAsianBlack or African AmericanHawaiian or Pacific IslanderWhiteOther racesI choose not to shareGirl's EthnicityHispanicNon-HispanicI choose not to shareGirl's School Troop Number (If known) or other notes:Is there anything else you would like us to know?Name of Staff Submitting Information:* First Last
