Echota District Cub Scout Leader Basic Training
Register me (name) ________________________________ for the (check one)
___ Sept 15      ___ Nov. 3      ___Jan. 26  Echota New Leader Training Session at Crown College.  I plan to attend and participate in the following training sessions.  (Check all that apply.)

___ Youth Protection     ___New Leader Essentials  
___Cub Scout Specific Training for:     ___Tiger Leaders
       (check only one)                            ___ Cub Leaders
                                                             ___Webelos Leaders
                                                             ___Cubmasters
                                                             ___Pack Committee Members

District:_______________  Pack # ______  My position is ________________

My phone number __________________(h) _________________(work- optional)

My address _______________________________________________________
    Enclosed is my check for $12 ($15 after the deadline).  Deduct $9 if you already have your leader manual.

__ Charge my registration fee of $__ to my MasterCard or Visa.

__ MasterCard number:____________________
     Expiration date:        ____________________
     3-digit security code number on back of card: ________

__ Visa Card number:______________________
      Expiration date:    ______________________
      3-digit security code number on back of card:________
Fill in and return to:

Echota District Cub Scout BLT
Great Smoky Mountain Council
P. O. Box 51885
Knoxville, TN  37950-1885
return to Echota District
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