Request for Checking Account (New or Update)
Troop Account Signers should utilize this form to request a new checking account or to make changes to an existing checking account.
Name of person completing this form:
*
First Name
Last Name
Email of person completing this form:
*
example@example.com
Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Troop Number:
*
Service Unit (if known):
Region/Closest Regional Office:
South Central/Wichita
Southwest/Garden City
Northwest/Hays
North/Salina
East/Emporia
Type of Request:
*
New Checking Account
Change of Signers - Existing Checking Account
Change of Banks - Existing Checking Account
Closing - Existing Checking Account
Other - Existing Checking Account
For a new account, is this for a now forming or recently formed troop?
*
Yes
No
For a new troop, is the troop requesting Start Up Funds?
*
Yes, please send Start Up Funds
No, we do not qualify for Start Up Funds or have already received a Start Up incentive.
For an existing account, provide a summary and explanation of changes needed. The next page will ask for additional details regarding NEW or CONTINUING signers.
*
Back
Next
Primary signer for the account (will receive bank statements and be responsible for completion of yearly Troop Finance Report):
*
First Name
Last Name
Has this signer completed Financial Management training and submitted the quiz, including agreement to Girl Scouts of Kansas Heartland checking account and financial requirements?
*
Yes
No
Unknown
Address for primary signer (will receive bank statements):
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Secondary signer for the account:
*
First Name
Last Name
Has this signer completed Financial Management training and submitted the quiz, including agreement to Girl Scouts of Kansas Heartland checking account and financial requirements?
*
Yes
No
Unknown
Additional signer for the account (if needed):
First Name
Last Name
Has this signer completed Financial Management training and submitted the quiz, including agreement to Girl Scouts of Kansas Heartland checking account and financial requirements?
Yes
No
Unknown
Would you like debit cards for this account?
*
Yes, in the primary signer's name
Yes, in the secondary signer's name
The troop already has a card and no changes need to be made
The troop already has one card, but would like to add a second card for another signer
No, we do not want a debit card
Name of additional card holder:
First Name
Last Name
Back
Next
Bank Name:
*
Bank Address/Branch Location:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Bank Phone Number, if known:
Please enter a valid phone number.
Format: (000) 000-0000.
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Next
For account closures, reason for closing this bank account
*
Troop is Disbanding/Graduating
Troop Finance Report is past due
Other
Final Troop Finance Report
Disbanding and Graduating troops are required to submit a mini finance report to show how the troop used their troop funds since the previous finance report. Please begin with the ending balance on your most recently approved Troop Finance Report and fill in the categories below and submit your receipts, or ending bank statement.
I have obtained all bank statements since the last Troop Finance Report was completed
Yes
No, they still need to be obtained prior to closing
Beginning Balance:
*
All Income/Deposits Since Beginning Balance:
Meeting Supplies/Activities/Event Expenses:
Community Service Expenses:
Renewal/Lifetime Membership Expenses:
Other Expenses:
Final Troop Finance Summary Notes:
Closing Balance:
*
Please attach last bank statement, a scan of last receipts/checks, or a detailed record of troop funds spreadsheet.
*
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Is there anything else we need to know to process your checking account request?
Submit
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