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
*
Girl Scouts of West Central Florida (GSWCF)
Other
Troop Number
*
Email
*
Phone Number
*
-
Area Code
Phone Number
What is your preferred form of contact?
Email
Phone
Would you like to pick up your patch or pay shipping?
*
Pick up my patch
Pay $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)
*
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.
Shipping
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Shipping
$
5.95
First Class Shipping
Total
$
0.00
Payment Method
Credit Card
First Name
Last Name
Credit Card Number
Security Code
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Expiration Month
2021
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Expiration Year
Billing Address
Street Address
Street Address Line 2
City
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Postal / Zip Code
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Other
Country
Patch Name
Hispanic Heritage
Uniforms in Action
4Her
4Family
I am a B5
VTK - Volunteer Toolkit - Base
VTK - charm 1
Food Allergy Research and Education (FARE)
Number of Girls who have completed or will complete the patch program.
*
Would you like to request another patch?
Yes
No
Number of Girls who have completed or will complete the patch program.
Patch Name
Hispanic Heritage
Uniforms in Action
4Her
4Family
I am a B5
VTK - Volunteer Toolkit - Base
VTK - charm 1
Food Allergy Research and Education (FARE)
Would you like to request another patch?
Yes
No
Number of Girls who have completed or will complete the patch program.
Patch Name
Hispanic Heritage
Uniforms in Action
4Her
4Family
I am a B5
Would you like to request another patch?
Yes
No
Number of Girls who have completed or will complete the patch program.
Patch Name
Hispanic Heritage
Uniforms in Action
4Her
4Family
I am a B5
VTK - Volunteer Toolkit - Base
VTK - charm 1
Food Allergy Research and Education (FARE)
Submit
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