2023 Staff Application

Person Applying for Staff Position
Full Name*
First Last
Age as of June 1, 2023*
- 14 - 15
- 16 -17
- 18 - 21
- 21+
Gender*
- Male
- Female
Phone Number*
Type of Phone*
Email Address*
Address*
Street Address Address Line 2 City State ZIP Code
BSA Registration*
- Current
- Previous
- Never
BSA Membership #*

This number can be found in your my.scouting account or scoutbook
Current Rank

In the case of a youth still a scout
Highest Rank Attained

In the case of a former scout or adult
Applicant's Shirt Size (Polo Shirt)*
Work Availability
Emergency Contact Information
Contact Name*
First Last
Contact Phone*
Contact Email*
Relationship to applicant*

Example: Spouse, Mother, Father, Etc.
Is address same as applicant?*
Contact Address*
Street Address Address Line 2 City State ZIP Code
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Person Applying for Staff Position