GSWCF Free Patch Program Order Request

GSWCF Free Patch Program Order Request

Use this form to request patches for our Council Patch Programs that have free patches only. Please remember that all of our free patches are available WHILE SUPPLIES LAST. While we are able to provide these patches for free for members of GSWCF, there may be a charge for requests from other councils, which would be noted in the patch description at gswcf.org/patchprograms.
Troop Leader/Adult Name*

First Name Last Name
Girl Scout Council Name*
Troop Number*
County
Email*
example@example.com
Phone Number*
What is your preferred form of contact?

EmailPhone
Would you like to pick up your patch or pay shipping?*

Pick up my patchPay $5.95 Shipping
When is the most convenient date/time for you to pick up the patches at the Leadership Center 4610 Eisenhower Blvd, Tampa? (Between 10am - 4pm, Monday-Friday) Type N/A if being mailed*
Provide the address where your patches should be shipped: *
Patches can only be shipped to one address, splitting orders and shipping to separate locations is not available.

Patch Name
Number of Girls who have completed or will complete the patch program. (0 - if selecting the leader earned only VTK patch)*
Would you like to request another patch?
Number of Girls who have completed or will complete the patch program.
Patch Name
Would you like to request another patch?
Number of Girls who have completed or will complete the patch program.
Patch Name
Would you like to request another patch?
Number of Girls who have completed or will complete the patch program.
Patch Name
Should be Empty: