Request for Financial Assistance

Request for Financial Assistance

Individual girl requests for program events or uniforms
Girl Scouts of Western Ohio provides financial assistance to individual applicants based on specific financial needs, and the applicant's compliance with the financial assistance philosophy of the Girl Scouts.

Financial assistance can be provided for Girl Scout uniforms, grade-level handbooks, and/or events.

Please review the Financial Assistance Application Policies and Procedures prior to filling out the form below.
Section I. Applicant Information

To be completed by the caregiver.
Girl's Name

First NameLast Name
Troop/Group #
Parent/Caregiver's Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Caregiver's Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Current Grade
Age
School District
County
Is the applicant a registered member of Girl Scouts?
Financial Assistance Request
I am requesting financial assistance for:
I am requesting financial assistance for:
Financial Assistance: Uniform
Has your troop collectively decided to wear uniforms?
My troop plans to/has participated in this year's Girl Scout Cookie Program.
Will your troop participate in either the Fall Product or Girl Scout Cookie Program?
I understand that we must contribute at least $5 in order to be eligible for uniform assistance (note: payment is expected at the time of purchase).
I understand that we must contribute at least $5 in order to be eligible for uniform assistance (note: payment is expected at the time of purchase).

Financial Assistance: Activity or Event
Name of activity or event
Event Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Event Location
How are you attending this event?
Troop Leader Name

First NameLast Name
Troop Leader Email
example@example.com
Troop Leader Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Provide a description of the event/activity
Optional: Upload an image of the event information (flier/screenshot)

Cancelof
Has your daughter's participation in this activity been confirmed?
Parent/Caregiver answer: I want my daughter to participate in this activity because...
Girl Scout answer: I want to participate in this activity because...
Does this applicant have a specific and distinct financial need?
Would the applicant be able to participate in the event/activity and/or purchase a uniform without financial assistance?
Cost of program or event
Amount caregiver can pay (caregivers are required to pay a portion of the event fee)
Amount of financial assistance requested
Calculated based on previous responses
(previous) Amount of financial assistance requested:
Please verify that you have reviewed and understand GSWO's Financial Assistance Application Policies and Procedures.
Please verify that you have reviewed and understand GSWO's Financial Assistance Application Policies and Procedures.
Parent/Caregiver Signature
Today's Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Please verify that you are human
Should be Empty:

Rows	Items requested? (yes/no)
Sash/tunic (tunics are for Daisies only)
American Flag
Council ID Set
Troop Numbers
Insignia Tab
World Trefoil Pin
Grade-level Handbook

Section I. Applicant Information

Financial Assistance Request

Financial Assistance: Uniform

Financial Assistance: Activity or Event