Staff Application

Alpha Lupus

Title Text.

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

-

Email *

Highest Scout Rank *

Troop # *

Scout Master *

Troop / Pack Position *

How Old are you? *

14-17 18-20 21+

Best time to Call *

Can you attend staff training Jan 13 - 15, 2011 *

Yes No

Which weekends can you attend? (Please select at least 2) *

Jan 20 - 22 Feb 3 - 5 Feb 10 - 12

Do you have your own appropriate winter camping gear? *

Yes No

Do you have prior winter camping experience? If So where? *

Do you have any special skills that would benefit the job? *

Why Do you Want to Be On Staff? *

Contact Webmaster with an issues at: [Christopher.Leither@gmail.com]