Thank you for taking the time to help us update our records. You DO NOT have to be a current member of the Pocumtuc Lodge to complete this form - in fact we urge former members Allogagan or Memsochet as well as Pocumtuc 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 *   Select Date
Address *  
City *  
State *  
Zip *  
E-mail Address: *  
Home Phone  
Business Phone  
Cell Phone  


Current Scout Information

    
Are you currently a member of the Boy Scouts? *  
Other Council Name  
Are you currently an active member of the Order of the Arrow *  
If you are not an active member of the Pocumtuc Lodge, which Lodge are/were you a member of?  
Current Unit Type  
Current Unit Number  
Honor *  
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 the OA
(give dates if you know them)		  
What Troop were in when you were elected  
What Council?  
List any other information you think would be helpful  
Comments / Questions  

* Required

  

 
 

 

 
 

 
   
 © Copyright 2008-2009
 Pocumtuc Lodge
 Western Massachusetts Council, BSA