Girl Scout Program Request

1831 Traver Road Ann Arbor, Michigan 48105 | Phone 734-997-1553 |

Please complete the following form to request an outreach program.

Once you've completed the form, a LSNC representative will call you to confirm date, time and program availability. Requests are not guaranteed until you speak with a LSNC representative.
For more information, please contact our Main Office at 734-997-1553.

Contact Name *

Contact E-Mail *

Contact Phone Number *

Troop Number *

Troop Location *

Address (Street, City, Zip Code) *

Grade Level *

Daisies (K-1)

Brownies (2-3)

Juniors (4-5)

Cadettes (6-8)

Number of scouts *