Community Service Bar Final Summary

This form is to be used after completing your pre-approved* community service hours.

*If you did not request pre-approval for your community service, please do so now. Please note that requesting retroactive approval does not guarantee it will be granted.

Instructions:

Submit this form for community service at your pre-approved organization within one year of council approval.
Attach your signed Community Service Log.
Allow 7-10 business days for council to review and verify your hours.
Once your final summary is approved, you will receive a congratulatory letter, which you can use at the GSNYPENN Girl Scout store to purchase your award pin.

If you have any questions after submitting your final report, please contact us at info@gsnypenn.org.

Girl Scout Name:*

First NameLast Name

Troop # or Juliette: *

Email:*

Phone Number:

Please enter a valid phone number.

Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Girl Scout Level:*

CadetteSeniorAmbassador

Date you received council pre-approval

Month and Year

Organization that benefitted from your service:*

Organization Contact Name : *

Organization Contact's Title: *

Email for Contact:*

example@example.com

Phone Number for Contact: *

Please enter a valid phone number.

Address of the organization: *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Please share your volunteer experience. What duties did you perform? How did your service impact the organization? What skills did you use that you've learned from Girl Scouting? Include anything else you wish to share! *

Log of Hours:

Please upload a typed document that includes the organization's contact signature to verify the completion of your hours. Accepted file formats include Word, Excel, or any other typed document such as a letter from the contact. Please refrain from uploading a photo of a handwritten document, as these can be difficult to read.

Please attach a log of hours signed by the organization.*

Do not submit a photo of a handwritten log..