Member Information Form

Thank you for your interest in Shawnee lodge. Once you submit this form, our team will make sure that you are up to date in our membership database. Please allow up to one week for the membership system to be updated after submitting the form. Should we need any additional information, a follow up email will be sent form help@shawneelodge.org Please answer all the questions below with the most current, up to date information.

First Name

Middle Name

Last Name

Gender

BSA ID

*current BSA ID

Date of Birth

Chapter

Unit Number

Please also include unit type (Troop/Crew/Pack)

Email Address

Phone Number

Phone Number Type

Street Address

City

State

Zip Code

Ordeal Date

Please enter an approximate date if unknown. (ex. if you know it was around 1985, enter 1/1/1985)

Brotherhood Date

Please enter an approximate date if unknown. (ex. if you know it was around 1985, enter 1/1/1985)

Vigil Date

Please enter an approximate date if unknown. (ex. if you know it was around 1985, enter 1/1/1985)

Comments

If you have any other comments about your membership, please put them here

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Supporting Documents

If you have any supporting documents, you can attach them here. Documents are not required, but always appreciated if they are avalible.

Attach file

Drop files here

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