The President's Volunteer Service Award Application for Certification

As of May 27, 2025, the President’s Volunteer Service Award (PVSA) program has been temporarily paused. No details have been provided regarding the reason for the pause or when the program will resume. AmeriCorps has stated that it will notify certifying organizations once the program is active again. Once the program has resumed, this form will be unlocked for use. We appreciate your understanding.

If you have questions, you may reach out to: PVSA@americorps.gov
The President's Volunteer Service Award Application for Certification
This award recognizes Girl Scouts for their community service efforts over a 12-month period of your choice. It is a Presidential honor, initiated by President Bush in 2003, to recognize the valuable contributions of volunteers nationwide who serve others through their volunteer activities. As a certifying organization, GSNYPENN will identify eligible Girl Scout recipients, verify their service hours, and distribute the award. Complete and submit this form to apply.

Criteria for the President's Volunteer Service Award (PVSA):
- United States citizen or lawful permanent resident of the United States (i.e., green card holder)
- Must be at least five years old
- Completes eligible service within a 12-month period (for annual Bronze, Silver, and Gold Awards) and over a lifetime (for Lifetime Achievement Awards)
- GSUSA member during the 12-month period of service
Eligible Service:
- Unpaid acts of volunteer service benefitting others. Service through National service programs that provide a stipend (e.g., Peace Corps, AmeriCorps) may count towards the Lifetime Achievement Award, but not for the annual Bronze, Silver, and Gold Awards.
- Travel stipends, transit/parking passes, membership passes, expense reimbursements, and other nominal volunteer support do not impact service eligibility
Eligible Service does not include:
- Donating funds
- Political lobbying (Non-partisan voter registration is an eligible activity)
- Religious instruction
- Conducting worship service
- Proselytizing
- Volunteer service performed as part of court-ordered community service
- Serving only family members
The PVSA website provides additional information, including the hours required to earn awards in each age group.
This form is currently locked.
Name of person filling out this form (nominator): *

First NameLast Name
Email: *
example@example.com
Phone number:*
Please enter a valid phone number.
Ordering and Delivery of Awards
- A council-wide order is placed once per year each January, so please plan accordingly. The application and record of service must be received by December 31 of the current year to receive council recognition the following April during Volunteer Recognition Month.
- Award delivery times may vary and depend on when AmeriCorps processes the PVSA applications.
- You will receive an email when the awards are ready for pickup at the service center indicated on this application.
Which Service Center would you like to pick up your package from:

HorseheadsMaine (Binghamton area)New Hartford (Utica area)Seneca FallsSyracuseWatertown
Award Nominees
- A log of verified activities and hours for each individual must be attached to this form.
- Service hours earned with other organizations (school clubs, church groups, etc.) must be accompanied by a statement from an organization representative certifying those hours.
Please list each nominee's full name, age, and total number of service hours.*
Nominee(s) are (check all that apply):

Registered youth members (Ages 5-17)Registered adult members (Age 18 or older)
Associated troop numbers:
Service Unit numbers:
Log of Hours:

DO NOT upload photos of handwritten or typed documents, as they are difficult to read. Please upload a Word or Excel document.
Please attach a typed log for each Girl Scout volunteer, including their full name, a detailed list of activities, and the corresponding dates and hours worked.*

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If submitting hours from another organization, please upload a document verifying those hours with the signature and contact information of the organization representative.

A statement on the organization's letterhead or an email from the representative is preferred.
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Do we have permission to include individuals' names and hometowns in council press releases and media materials related to receiving this award?*

Yes, all individuals have given permissionYes, but only some individuals have given permission (list names below)No
Please provide a list of individuals who have granted permission for their names and hometowns to be included in council press releases and media materials. (If all individuals listed on this application have agreed, you do not need to fill out this section.)
If you would like us to include a photo, such as a headshot or an image of the individual engaged in volunteer service, please upload a high-quality photo that clearly shows the individual’s face.

By sharing this photo, you grant us permission to use it.
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Verification

By entering my name below I certify that these hours are valid service hours for the individual(s) listed above.
Name*

First NameLast Name
Date*

MonthDayYear
You will be notified via email once the council has certified the hours you submitted.

Thank you for helping celebrate and recognize the meaningful contributions of Girl Scouts to the community!

Questions: info@gsnypenn.org
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The President's Volunteer Service Award Application for Certification

Award Nominees

Verification