Exploring Program Membership Form

Youth Information

Thank you for your registration and welcome to Exploring, the Boy Scouts of America's character and career development program for youth. Please fill out the information below, and then inform your post or club leadership that you have of your completed this registration. If you do not know how to reach your post or club's leadership, please send a message to Exploring Executive at corina.zepeda@scouting.org.

Name*

First Last

Address*

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

Email*

Phone*

Do you know the Post # you are interested in?*

Yes
No

Post #

What career field(s) interest you?*

Date of Birth*

Grade in school*

School

if applicable

Gender*

How did you hear about Exploring?

Other

Parent/Guardian Information

Name*

First Last

Address*

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

Email*

Phone*

Relationship to student

Gender*

Date of Birth*

Occupation

Employer

Would your company possibly be interested in hosting Exploring?*

Yes
No

Company Contact Person Name

First Last

Company Contact Person Phone

Company Contact Person Email

Parent's Signature*

Name

This field is for validation purposes and should be left unchanged.

Youth Information

Parent/Guardian Information

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