Mandated Reporter Training Certification Submission Contact InformationName* First Last Email*Please use the email address associated with your myGS account. Enter Email Confirm Email Zip Code* Which of these most closely describes your current position with GSGLA?*Community Partner/MemberCurrent Girl Scout MemberParent/GuardianService Unit Manager/Co-ManagerTroop Leader/Co-LeaderOther Service Unit VolunteerOther Troop VolunteerOther Not Listed AbovePlease Describe: Service Unit*400 Rancho Foothills401 Alhambra/Rosemead/Santa Fe Trails402 Bonita403 Claremont404 Anita Oaks/Mission Camellias405 Chino406 Canon Trails407 CV/Glendale408 Pomona409 River Trails411 Upland412 La Canada414 Monrovia/Duarte415 Las Caballeras416 Puente Hills418 San Marino419 Glendora420 South Pasadena421 Covina Oaks422 West Covina425 Crown Poppy426 Mt. View427 Campo Verde428 Ontario/Montclair429 Gateway450 Chino Hills501 Compton/Lynwood502 Bellflower/Hollymount503 Belmont504 Lachen505 Holly Hills506 Highland Rose507 Lakewood508 Alamitos/Marina509 Westchester/Del Rey511 Culver City512 RDE/Sil-Dom513 Northeast Hills515 El Segundo516 East LA517 Southeast SU518 Willow Stone519 Lawnthornes522 La Brea Heights524 King Harbor526 North Redondo528 Manhattan Beach529 South Bay Four533 Marina538 Pali/Mali540 San Pedro (Avalon)542 Santa Monica543 S. Torrance545 Torrance546 Peninsula/Palo Verde601 Burbank604 Westside605 Rancho Calabasas606 Las Virgenes608 Palmdale612 Golden Savannahs616 Canyon Star617 Sagebrush624 Woodland Hills636 Kern640 Mission Rose641 Twin Oaks642 Heart of the Valley643 Stoneyridge644 Magnolia647 Lancaster649 Coyote Canyon650 North River903 StaffN/A or UnknownTroop # (Five Digits) Would you like your certificate to apply to any additional troops?* Yes No Please list any additional troop numbers. If providing more than one troop, please start each number with "Troop #".* Do you need to list an additional service unit (different than the service unit listed previously)?* Yes No Service Unit*400 Rancho Foothills401 Alhambra/Rosemead/Santa Fe Trails402 Bonita403 Claremont404 Anita Oaks/Mission Camellias405 Chino406 Canon Trails407 CV/Glendale408 Pomona409 River Trails411 Upland412 La Canada414 Monrovia/Duarte415 Las Caballeras416 Puente Hills418 San Marino419 Glendora420 South Pasadena421 Covina Oaks422 West Covina425 Crown Poppy426 Mt. View427 Campo Verde428 Ontario/Montclair429 Gateway450 Las Colinas501 Compton/Lynwood502 Bellflower/Hollymount503 Belmont504 Lachen505 Holly Hills506 Whilshire Park Village507 Lakewood508 Alamitos/Marina509 Westchester/Del Rey511 Culver City512 RDE/Sil-Dom513 Northeast Hills515 El Segundo516 East LA517 Southeast SU518 Center City519 Lawnthornes522 La Brea Heights524 King Harbor526 North Redondo528 Manhattan Beach529 South Bay Four533 Marina538 Pali/Mali540 San Pedro (Avalon)542 Santa Monica543 S. Torrance545 Torrance546 Peninsula/Palo Verde601 Burbank604 Westside605 Rancho Calabasas606 Las Virgenes608 Palmdale612 Golden Savannahs616 Canyon Star617 Sagebrush624 Woodland Hills636 Kern640 Mission Rose641 Twin Oaks642 Heart of the Valley643 Stoneyridge644 Magnolia647 Lancaster649 Coyote Canyon650 North River903 StaffN/A or UnknownIf you would like to be listed under more than two service units, please email livescan@girlscoutsla.org.Certificate InformationWhich will you be providing?* AB 506 state mandated reporter training certificate Current mandated reporter professional license Other evidence of mandated reporter occupation Date of Training Completion MM slash DD slash YYYY Please upload your certificate, license or other evidence here:*Max. file size: 100 MB.If you completed the Girl Scout specific training module on the Mandated Reporter Training website, and you would prefer to not purchase the certificate, a screenshot will suffice. To do so, please login to your account and navigate to the "certificates" page. Once there, you can take a screenshot as shown in the example below. You will then save that screen shot and upload it here. Today's Date* MM slash DD slash YYYY CAPTCHA