Volunteer Essentials 2014-15 | Page 149

INTENT TO TRAVEL FORM Please submit an Intent to Travel Form according to the table below based on the trip you would like to attend. Type of Trip: 3 or More Nights Trip 1 Week Trip 7 or More Nights Trip International Trip Cruise Submission of Intent to Travel Form: 6 months prior 8 months prior 1 year prior 2 years prior 2 years prior TRAVELER or ADULT ADVISOR OF GROUP INFORMATION Contact Name: Address: Street City Email Address: State Phone Number: Position in Girl Scouting: Membership Expiration Date: Sites/Countries to be Visited: Date of Departure: Number of Adults Traveling: Date of Return: Number of Girls Traveling: Age Range: Signature of Traveler or Adult Leader of Group: Council Endorsement of Individual Member and/or Group Planning to Travel: Council Name: Signature for Council: Position in Girl Scouting: Date: Fax Completed form to 814-734-7701 or Mail completed form to: Girl Scouts Western PA C/O Program Manager 5681 Route 6N Edinboro, PA 16412 145 Zip