Change Membership and Troop/Council Transfer Form

CURRENT COUNCIL
Current Council Name *
Impacted Member(s) *

Girl Only Adult Only Family
Impacted Member Name *

First Name Last Name
Member's GSUSA ID
Person Completing Form *
Primary Phone Number *

Area Code Phone Number
E-mail Address *
Previous Address (Transferring From) *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Current Council Comments/Questions
Troop Number Transferring From
New Troop Number
Updated Address (if applicable)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Updated School (if applicable)
Updated Grade (if applicable)
Troop Transfer Comments
NEW COUNCIL
New Council Name
New Troop Number (if known)
New Address (Transferring To) *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
New School
Grade
New Council Comments/Questions
Should be Empty: