Service Unit Encampment Application

Please provide the following information:

Association

Service Unit 

Service Unit Manager

Address  

City 

State 

Zip Code

Day  Telephone

Evening Telephone

Email

Service Unit Encampment Coordinator

Address  

City 

State 

Zip Code

Day  Telephone

Evening Telephone

Email

Date of SU Encampment coordinator training

Service Unit First Aider

Type of Certification

Expiration date

(Level 2 needed if more than 200 participants)

APPROXIMATE NUMBER OF PARTICIPANTS:

Overnight Day only Troops

PLEASE COMPLETE THE FOLLOWING

****In order to process your application you must indicate the date of your last Service Unit Encampment on a GSCNC campsite****

Last date and place your Service Unit had an encampment on a Council campsite:

Last Date
Last Location

Please list camp(s) and date(s) requested in order of preference

1

2

3

4

5