Scout Program Request Form

    First Name*

    Last Name*

    Troop Number*

    Email Address*

    Telephone Number*

    Address*

    City*

    State*

    Zip Code*

    County*

    Comments:

    Which educational program are you interested in?

    Village LifeWoodland EncounterMeadowcroft Rockshelter TourArchaeology Merit BadgeIndian Lore Merit BadgeMeadowcroft Plants!Meadowcroft Rocks!

    Approximate Number of Attendees*

    Requested Visit Date*

    First Choice:

    Second Choice:

    Camping?

    YesNo

    Do you want to sign up for the History Center's scouting newsletter?

    YesNo

    Do you want to sign up for Meadowcroft's email newsletter?

    YesNo