Pack 1232 - Selkirk Volunteer Fire Company No 2 201841949 APPLICATION DETAILS Application ID 201841949 Parent / Guardian MemberID ID 136570423 Applicant Member ID 141656822 Applied to Organization Twin Rivers Council 364, Fort Orange 01, Pack 1232, Selkirk Volunteer Fire Company No 2 Submitted Date 07/26/2025 00:00:00 Current Status Completed Current Status Date 07/26/2025 18:43:45 BSA Youth Registration (Trad.) $85.00 Council Fee $50.00 Administrative Fee OLR $2.36 1 STEP 1: YOUTH INFORMATION First Name Julia Last Name Kent Age 10y Gender Female Grade Fifth Grade Ethnic Background Caucasian/White Country USA Address Line 1 66 Montrose Drive Address Line 2 City Delmar State NY Zip Code 12054 Personal and Confidential for Authorized BSA Use Only Page 1 YOUTH APPLICATION

Pack 1232 - Selkirk Volunteer Fire Company No 2 201841949 2 STEP 2: PARENT INFORMATION First Name Kenneth Middle Name Last Name Kent Age 42y Gender Male Ethnicity Caucasian/White Relationship to youth Daughter of Country USA Address Line 1 66 Montrose Drive Address Line 2 Address Line 3 City Delmar State NY Zip 12054 Phone Number 001 (518) 852-6703 Email Address kenny.kent83@gmail.com Personal and Confidential for Authorized BSA Use Only Page 2 YOUTH APPLICATION

Pack 1232 - Selkirk Volunteer Fire Company No 2 201841949 2 STEP 3: ADULT PARTNER INFORMATION First Name Middle Name Last Name Age y Gender Ethnicity Relationship to youth Country Address Line 1 Address Line 2 Address Line 3 City State Zip Phone Number Email Address Personal and Confidential for Authorized BSA Use Only Page 3 YOUTH APPLICATION

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Original PDF: Julia Kent Application.pdf