Thank you for taking the time to help us update our records. You DO NOT have to be a current member of the Memsochet Lodge to complete this form - in fact we urge former members to update their information with the Lodge. All information is held in confidence.

* Indicates a required field.

Contact Information  
  First Name *  
  Middle Name or Initial  
  Last Name *  
  Nickname (The name you go by)  
  Date of Birth  
  Address *  
  City *  
  State *  
  Zip *  
  E-mail Address: *  
  Home Phone  
  Business Phone  
  Cell Phone  
       
Current Scout Information  
  Are you an Eagle Scout?   Yes
No
  Are you currently a member of the    
Boy Scouts? *		  
  Other Council Name  
  Are you currently an active member of the   
Order of the Arrow *		   Yes, I am a member of Memsochet Lodge
No, I am not currently active in the OA
Yes, but I am now a member of a different Lodge
  Other Lodge Name  
  Current Unit Type  
  Current Unit Number  
  Honor *   Ordeal
Brotherhood
Vigil
  Date of your Ordeal
(as complete as you can remember)		  
  Date of your Brotherhood
(as complete as you can remember)		  
  Date of your Vigil
(as complete as you can remember)		  
  Vigil Name  
  Translation  
  List any OA awards or honors  
  List any positions you have held in Memsochet Lodge (give dates if you know them)  
       
Historical Scout Information  
  What Troop were in when you were elected  
  What Council?  
  List any other information you think
would be helpful		  

 

* Required

  

 

 
 
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