GIRL SCOUTS OF KANSAS HEARTLAND: COUNCIL CARES

GIRL SCOUTS OF KANSAS HEARTLAND: COUNCIL CARES

COUNCIL CARES APPLICATION AND GUIDELINES: Council Cares awards are granted only to current registered Girl Scouts. Council Cares awards are granted based on the financial need and availability of funds, with priority given to first-time applicants. Council Cares awards are not designed to replace program credits earned by Girl Scouts. Council Cares awards may be requested for part or the entire amount needed and may be approved in whole, in part, or denied. This form must be completed by the PARENT/GUARDIAN. Do not pay in advance for uniform items or Journey book and then request a refund. Incomplete applications will be returned to the parent/guardian and will need to be resubmitted for consideration. Please allow 5-7 business days for a reply via email.
Program Age-Level (Check one of the following): *

Daisy (K-1) Brownie (2-3) Junior (4-5) Cadette (6-8) Senior (9-10) Ambassador (11-12)
Girl Name: *

First Name Last Name
Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
County of Residence: *
Phone Number: *

Area Code Phone Number
Email: *
Name of Parent(s) or Guardian(s): *

First Name Last Name
Occupation of Parent(s) or Guardian(s): *
Annual Household Income Level: *
Number of Dependents in Household: *
Number of Adults in Household: *
Number of girls in Girl Scouts: *
Did your daughter participate in the previous Fall Product Program? *

Yes No
Did your daughter participate in the previous Cookie Program? *

Yes No
Are there extenuating circumstanes that affect your income?
Check all items for which assistance is being requested, and sign and date the form. *

Uniform- Tunic for Daisies and Sash for all other levels Troop Numbers Council ID Set Flag Insignia Membership Pin Journey Book (if troop will be completing together, obtain book title from Troop Leader)
Sash Size *

Regular X-Long
Tunic Size *
Parent/Guardian Signature *

First Name Last Name
Date

Month Day Year
Notes:
If your council cares application is approved, would you like your uniform shipped to the address above? *

No, I prefer to shop in person at one of the council stores in Wichita or Hays Yes, ship it to me - Allow 5-7 business days for processing. Shipping only available to customers OUTSIDE of Sedgwick and Ellis counties.
Council Cares awards help girls enjoy the benefits of Girl Scouting.The Council appreciates and welcomes donations designated for the GSKH Council Cares Fund.
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GIRL SCOUTS OF KANSAS HEARTLAND: COUNCIL CARES

Council Cares awards help girls enjoy the benefits of Girl Scouting.The Council appreciates and welcomes donations designated for the GSKH Council Cares Fund.