MEMBER INFORMATION SHEET
What is your name?
What is your mailing address?
What is your city, state, and zip?
What is your e-mail address?
What is your home phone number?
What is your work phone number?
What is your date of birth?
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
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31
Year
What is your place of birth?
(The next question is for youth members only.)
What Troop are you in?
(The next question is for adult members only.)
What is your Scouting Position? (indicate Pack/Troop/Post and number or District/Council)
Type of Unit
Pack
Troop
Post
District
Council
Unit # or District Name
Position Held
What is your OA Membership Status
Ordeal
Brotherhood
Vigil
What was the date of your Ordeal?
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
2
3
4
5
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23
24
25
26
27
28
29
30
31
Year
What was the location of your Ordeal?
City:
State:
Country:
Council:
Lodge:
What was the date of your Brotherhood?
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
2
3
4
5
6
7
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10
11
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13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
What was the location of your Brotherhood?
City:
State:
Country:
Council:
Lodge:
What was the date of your Vigil?
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
What was the location of your Vigil?
City:
State:
Country:
Council:
Lodge:
Please Note: Dues of $5.00 are due by December 1, 1998. National has informed us there will no longer be a grace period - Our Charter must be received at National by December 31, 1998. Please send your dues to the Council Office, no later than December 1, 1998. Make check/money order payable to the Order of the Arrow. If you send your dues to the office through the mail, remember, do NOT send cash.
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