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Name:
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Web site:
Interests:
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Address:
Phone #:
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Unit Number:
Date of Birth:
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Honor Achieved:
Ordeal
Brotherhood
Vigil
District/Chapter:
American Elm
Black Walnut
Buckeye
Great Oaks
Hawthorn
Old Sycamore
Tamarack
What Committees are you interested in?:
Ceremony Team
Troop Representative Committee
Website Committee
Cook Crew (Adults Only)
Publications Committee
Dance Team
Brotherhood Conversion Committee
Elangomat
Fundraising Committee
Special Events Committee
Membership Committee
Rank:
1st Class
Star Scout
Life Scout
Eagle Scout
An Old Goat
What lodge do you belong to?:
Mawat Woakus Lodge
Other Section C4-B Lodge
A Section C4-A Lodge
A Section C2-C Lodge
Other Central Region Lodge
Southren Region Lodge
Northest Region Lodge
Western Region Lodge
None - I'm a Scouting Professional
None- I'm a Adult Leader
None - I'm a youth (21 yrs and younger)
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