EmailMe Form - Girl Scout Grad/Alum Contact Information

Name *

First Last

Troop #

I am a Lifetime Member

Yes

No

I am not currently a Lifetime Member but I would like more information.

I am a Gold Award Girl Scout

Yes

No

I would like more information about joining the Gold Award Alliance.

Email (Please share your personal or new school email) *

Phone

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Graduation Year *

How would you like to receive alum information:

Email

Phone

Text

Please upload a current "headshot" photo of you.

If you have a photo of yourself in your Girl Scout uniform great. You can also upload your Senior photo. Gold Award or other headshot.

I release Girl Scouts of Orange County (GSOC), its officers and employees, and each and all persons involved from any liability connected with the taking, recording, digitizing, or publication and use of interviews, photographs, computer images, video and/or sound recordings provided. I further waive all rights I may have to any claims for payment or royalties in connection with any use, exhibition, streaming, web casting, televising, or other publication of these materials, regardless of the purpose, irrespective of whether a fee for admission or sponsorship is charged. I also waive any right to inspect or approve any photo, video, or audio recording taken by GSOC or the person or entity designated to do so by GSOC *

By clicking this box, I agree to the GSOC photo release form information above.

By clicking this box, I acknowledge that I have been fully informed of my consent, waiver of liability, and release of rights or claims to the submitted photo.

I own the rights to the attached photo and I agree for the submitted photo provided to be used for media/publicity purposes.

Please let us know where we can reach you in the Fall.

I will be staying in Orange County
I will be moving out of Orange County

If you are attending school in the Fall, let us know where?

Other:

If you are joining the military, let us know which branch?

Other:

What interests you about joining the Girl Scouts of Orange County Alum Network? (please select all that apply)

Reconnecting with other alum

Networking

Socializing

Participating in community service

Attending events

Staying current on what's up with Girl Scouts

Working directly with current Girl Scouts

Countinue my journey by becoming part of the community of Girl Scout philanthropists

Other (please specify)

Please rate your interest level in attending the following events. Then indicate how far you would be willing to drive to attend an event of interest.

	Very interested	Maybe	Not interested	0-10 miles	11 - 25 miles	25+ miles
Networking event after work
Networking event on the weekend
Family gathering at a GSOC property
Overnight at Camp Scherman
Volunteer at a event
Volunteer at an outdoor event or activity
Participate in a GSOC sponsored Service Project
Help Lead or support a troop
Help lead or support badgework

When would you be most likely to attend a GSOC networking event? (please select all that apply)

Weekday - daytime

Weekend daytime

Weekday - evening

Weekend - evening

Other (please specify)

How often would you be able to attend a Girl Scouts of Orange County event?

Monthly

Semi-annually

Quarterly

Annually

What other professional associations and/or social groups are you currently a member of?

Which age range are you in?

18-25

50 and older

26 - 49

Prefer not to answer

Would you be interested in participating in a leadership committee to increase alum engagement?

YES

Not at this time.

Maybe, what doesit entail?

Please contact me so I can get additional information on getting involved. My preferred method of contact is

Please share in what way(s) Girl Scouts has impacted your life.