Contact Person Name___________________________________________ Address ___________________________________________________ City, ST Zip Code __________________________________________________ Work Phone ___________ Home Phone ___________ Cell Phone ___________ E-mail address _____________________________________________________ District:
Unit Number: ____________________________________________________
Number of Scouts: ______________________ Submit to: Glaciers Edge Council BSA, P.O. Box 14135, Madison, WI 53708-0135 or Email Donna.Machen@Scouting.org or Fax 608-273-8686 By February 5, 2016