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I would like to arrange for a speaker to talk with my organization about the Girl Scouts. Please contact me to discuss dates and times.

Name:
Address:
City:
State:
Zip Code:
Daytime Telephone #:
Evening Telephone #:
E-mail address:
Name of Group:
Meeting Location (City/State)

If you wish to download the form instead, you can do so in PDF format here or zipped Word format here and either email, fax or mail it to the GSCNC, PR Department, 4301 Connecticut Ave., NW, Washington, DC 20008 or email:  PR@gscnc.org

Fax 202/274-2161

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