Name: _____________________________________
Address:____________________________________
___________________________________________
City:______________________________State:_____
Phone:_______________________
Cell: Phone___________________
Scouting Position:________________________ Unit:__________ District: _____________________
Council:________________________ Years in Scouting:________ email:________________________
Enclosed is my deposit of $50 to hold my place (non-refundable). 2nd payment of $80 due April 30, 2003 and final payment $75 due by June 30, 2003
Mail to:
Connecticut Yankee Council
Attn. John Ralbovsky
60 Wellington Rd
Milford, Ct 06460-0032
Last updated: 12/24/02