Survey - Scout Program Request Form - San Diego Humane Society

Scout Program Request Form

Thank you for your interest in a San Diego Humane Society Education Program! Please complete the request form below. We will respond to your request via email within a week. If you have special questions or concerns, please indicate them in the notes section below and a phone call can be arranged if needed.

We offer Scout programs Wednesday through Saturday.

*1.

Question - Required - Your First and Last Name:

*2.

Question - Required - Your Email Address:

*3.

Question - Required - Your Phone Number:

*4.

Question - Required - Scout program you are interested in:
Please make at least 1 selection from the choices below.

	Project Wildlife
	Playful Paws
	Girl Scouts: Daisies
	Girl Scouts: Brownies
	Girl Scouts: Juniors
	Girl Scouts: Cadettes
	Girl Scouts: Other

5.

Question - Not Required - If other, please explain:

*6.

Question - Required - Troop #:

*7.

Question - Required - Troop zip code(s)

*8.

Question - Required - Number of Scouts:

*9.

Question - Required - Scouts' Ages:

*10.

Question - Required - Which of our campuses are you interested in visiting?

*11.

Question - Required - Please list three potential dates and times for your program:

12.

Question - Not Required - Please provide any additional information that is important for us to know about your Scout group: