Captain Signup

First Name *
Last Name *
City *
Zip/Postal Code *
Country *
State/Province *
Email *
Confirm email *
Phone Number *
Username *

(Please use your first name initial and last name. If the duplicate warning appears, please add a number starting with 1 and counting up to the end of the username.Example: John Doe will be jdoe)
Password *
Confirm Password *
Priest Name *

(Please leave out the prefix, unless other than "Father" (for example, Monsignor), as all correspondence will be directed with "Father" and the name listed in this field automatically.)
Priest Email *
Priest confirm email *
Troop Number *
Anticipated Charter Date *

(This date will be your annual re-charter date.)

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