General Information

Please fill in the following information. Please input the information as you listed it on your membership registration form this year. This information will be used to add your online learning record to your membership record. If you are not a registered Girl Scout member, but you have completed your volunteer screening process, please use the information listed on your volunteer screening paperwork.

Please Note: You will only have to fill-out this information once. To save your place in a test, bookmark the page. If you lose your bookmark, please visit www.GirlScoutsNorCal.org/onlinelearning to look up your online learning records.

* required

First Name*:
Last Name*:
Street Address*:
City*:
State*:  
Zip Code*:
Primary Phone*:
(###-###-####)

Secondary Phone:
(###-###-####)

Email*: