WEST MERCIA SCOUTS

Scouting in Dudley, Sandwell, Walsall, Wolverhampton and South Staffordshire.




	Join Us ...

Please use this page to register your interest in joining The Scout Network in West Mercia.

We will contact you in due course to provide you with the latest information on Scout Network.

18 - 25 Questionnaire

Please only complete this form if you haven't submitted a paper version

* We are asking those who are aged 18 - 25, and those approaching 18, to complete this form to help us to compile information in readiness for the launch of Scout Network.

Personal Information . . .


Name:
Surname:
Address:
Postcode:
Home Phone:
Mobile:
Email:
Date of Birth:		dd/mm/yyyy

Communications . . .
By which method would you like the Network to use to let you know the programme?
		By looking on the Scout Network website
		By email
		By Newsletter

By which means would you like to be informed of last minute changes?
		Email
		Text Message
		Phone

Scouting Information . . .
Are you currently a:
		Explorer Scout
		Ex-Venture Scout
		Helper/Instructor/Leader
		Scout Fellowship
		Neither of above

Which District do you belong to ?


Structure . . .
Would you want to be a member of . . .
District Based Network
College/University based Network
Activity Based Network (Mountaining, Gang Show)
Service Team Network

Other Information . . .
Please use this space to supply us with any other information,

Data Protection: The information submitted on this form will be used for the administration of Scouting only and not passed to a third party.