Sign up for Scout Leader Basic Training Spring 2001

Planning for Part 3 will be done during Parts 1 and 2.

Print, fill out, and mail this form:



Name ___________________________________________

Address ________________________________________

City ___________________________________________

State _____  Zip _______________________________

Phone __________________________________________

Troop # ______ Town ____________________________

Position in Troop ______________________________

(PLEASE CIRCLE DATES YOU ARE SIGNING UP FOR)

Part 1 - February 10, 2001 or April 7, 2001

Part 2 - February 22, 2001 or April 10, 2001

Please put additional names, addresses, etc. on a
separate sheet.

Please make checks payable to:
            Westchester-Putnam Coucil, BSA
Mail to:    41 Saw Mill River Road
            Hawthorne, NY 10532


# Participants ______ x $15.00 = $_____________

                          Acct. # 1-6801-926-20