2025 Fall Product Program Alert Form

2025 Fall Product Program Alert Form

INSUFFUCUENT FUNDS FOR SWEEP
The Fall Product ACH sweep will release December 5.

Submit this form if your account does not have the full amount you owe. If the reason is due to a family still owing the troop, include copies of any Girl Scouts’ signed caregiver permission slip, signed product receipts, and any other supporting information with your form. DO NOT pay delinquent Girl Scouts’ debts. This form must be submitted by December 2, 2025. (Please note: Changes to the sweep cannot be made after December 2)

Remember that funds from checks may not be immediately available. Plan your deposits in ample time.
Today's Date

MonthDayYear
Date
Community Number
Troop Number
Name of individual completing this form

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Position with Troop
Amount Available for Sweep 12/5/2025
If not fully paid, explain the reason funds are not available:
Estimated date for balance to be paid

MonthDayYear
Date
Upload other supporting information not related to a girl delinquency here:

Cancelof
If delinquency lies with an individual troop member(s), please fill out the following:
Girl #1 Name

First NameLast Name
Girl #1 Parent's Name

First NameLast Name
Girl #1 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Girl #1 Phone
Please enter a valid phone number.
Girl #1 Email Address
example@example.com
Action Taken for Girl #1
For Girl #1, upload copies of signed parent permission slip, signed product receipts, and any other supporting information.

Cancelof
Girl #2 Name

First NameLast Name
Girl #2 Parent's Name

First NameLast Name
Girl #2 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Girl #2 Phone
Please enter a valid phone number.
Girl #2 Email
example@example.com
Action Taken for Girl #2
For Girl #2, upload copies of signed parent permission slip, signed product receipts, and any other supporting information.

Cancelof
Should be Empty: