Scout Association/
Contingent Name: _________________________________________
Adult Name: _____________________________________________________
Mailing Address: ________________________________________________
______________________________________________________
email: ___________________________ FAX: ________________________
Phone (home): ____________________ (office):_____________________
Present Scouting Position:
___________________________________________________
Date of Birth: (month) ________________ (year) __________________
Height: _____________________ Weight: __________________________
(circle one): Male Female
Will you participate in Home Hospitality? Yes No
Do you have any special plans or requiest for Home Hospitality?
______________________________________________________
______________________________________________________
Language Skills: Do you:
( ) speak ( ) read ( ) write English?
Please list other languages spoken, and degree of fluency:
______________________________________________________________________
______________________________________________________________________
Scouting Background and Experience:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Hobbies, Skills, and Interests:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Occupation and Education:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Preferred Type of Staff Assignment (if any):
______________________________________________________________________
______________________________________________________________________
Do You Have Any Special Health or Diet Considerations
(Religion, Personal Preference, etc.) ?
______________________________________________________________________
______________________________________________________________________
Comments or Questions:
______________________________________________________________________
______________________________________________________________________
(Continue information and comments an additional sheets, as desired)
We appreciate your response, and welcome you to International Rendezvous '98!
Revised December 30, 1997 || Posted by the
Rendezvous'98 Web Crew