Change Membership and Troop/Council Transfer Form

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

Girl OnlyAdult OnlyFamilyOther
Impacted Member Name*

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

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

Street Address

Street Address Line 2

CityState / Province

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

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
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

CityState / Province

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