Financial Assistance Application

Applicant's Name*

First NameLast Name

Applicant is a:*

YouthAdult

What is your volunteer role, if applicable?

Caregiver's Name*

First NameLast Name

Email Address*

Please provide the email at which you receive Girl Scout communications.

Phone Number*

Troop/Juliette Number*

If you do not participate in a troop, or as a Juliette, please share how you participate in Girl Scouts

The applicant is requesting financial assistance for:*

Uniform and program materials from a Girl Scouts River Valleys shopRegistration fee for a Girl Scout River Valleys program eventRegistration fee for a Girl Scouts River Valleys resident camp sessionIndividual portion of registration fee for a Girl Scouts River Valleys troop camp sessionRegistration fee for a Girl Scout River Valleys adult trainingTroop DuesRegistration fee for a community/area or volunteer-led event or day camp

Grant Type for Email Subject

Program Event Financial Assistance

Girl Scouts River Valleys provides financial assistance for events operated by the council. This option should be used for both school-year events as well as summer programs that do not include overnights, like Bike Club.

Adults may receive financial assistance to cover costs associated with chaperoning events, or fees to attend council-led volunteer training.

Financial assistance is only provided for events run by Girl Scouts River Valleys. Please contact us if you have questions about whether the event you wish to attend will qualify.

Community/Area or Volunteer-Led Day Camp Financial Assistance

Financial assistance is provided to those attending Volunteer-Led Day Camps (a.k.a. Community/Area Day Camps) that are approved by Girl Scouts River Valleys. Please contact us if you have any questions about whether the camp you plan to attend is approved.

Each attendee must apply for financial assistance separately, but awards are sent to the community/area along with others, near the time of the event. Community/area volunteers will receive information about who was approved for financial assistance, and for what amount.

Any amount contributed by the troop or individual (any payment method) will be paid to the volunteers managing the event. Please include with your registration form, and contact the event organizers with any questions about registration

Resident Camp Financial Assistance

Girl Scouts River Valleys provides financial assistance for registration fees associated with council-led resident camps (which includes Adult + Me sessions). This form must be completed separately for each attendee requesting assistance.

Troop Camp Financial Assistance

Girl Scouts River Valleys provides financial assistance for registration fees associated with troop camps. This form must be completed separately for each attendee requesting assistance. Adults attending a troop camp as a chaperone are required to complete a background check in addition to having a Girl Scout membership.

Troop Dues Financial Assistance

Troop dues are sometimes requested of girl members to help cover a troop's costs for items such as meeting supplies, snacks, and small outings. These are most often requested in the first year, before troops have an opportunity to participate in product sales to cover their needs.

Troop dues are not intended to cover Girl Scouts River Valleys membership dues, program events, camps, or shop items. Those items should be applied for separately.

Name of program, training or camp event *

Community/Area Name or Number

This can be found through day camp promotional materials

Location

Example: Camp Lakamaga, Plymouth Community Center, Girl Scout Service Center, etc. Enter "virtual" for events with no physical location.

Start Date*

Date

Start Time*

Hour Minutes

AM/PM Option

Order Number*

Please connect with your troop leader that completed the registration to obtain the order number.

Registration Fee*

Please include the full member registration fee - do not subtract deposits, discounts, or coupons.

Camp Deposit*

Error

This form can only be used for a single applicant at one time. Please fill out the form separately for each attendee.

Specifically, fill out the form including only the girl attendee's information. Then complete it again for the adult attendee.

Troop Dues Charged Per Girl*

What will troop dues be used for?*

Troop Dues Note

Please apply for a shop financial assistance to cover uniform (and related items) or books. Please use troop dues financial assistance only for the dues amount minus the shop items

What is the amount you can pay towards this cost? *

Please include payments made with program credits and/or by the troop. Enter 0 if that applies.

What is the total troop dues financial assistance amount you are requesting?

What is the total camp registration financial assistance amount you are requesting?*

Does the applicant or applicant's family qualify for Free or Reduced Lunch?*

Yes, we qualify for Free Lunch.Yes, we qualify for Reduced Price Lunch.No, we do not qualify for either.I am not sure or we haven't applied.

Free and Reduced Lunch Status is Required

Free/Reduced lunch status is a key part of award criteria, so we must receive a "yes" or "no" response in order to consider your request.

Note: We are asking if your family qualifies for free and reduced lunch status. If you meet the income/family size criteria, respond "yes" even if you do not receive this assistance or if you have not formally applied.

If you are not sure if your family qualifies, you can review the federal school meal eligibility guidelines and then use the yes/no options above.

Any comments or questions?