Branch County Girl Scouts Fund
Please fully complete the application before submitting.
Applicant Information
Applicant Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Parent or Guardian Information
Parent or Guardian Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Troop Information
Troop Number:
*
Level of Girl Scout:
*
How long have you been involved in Girl Scouts?
*
Number of years
Are you are registered Girl Scouts?
*
Yes or No
Summer Camp Information
Camp Name
*
Date of Camp
*
Number of Days
*
Total Cost of Camp (please list a dollar amount)
*
How much can your family contribute towards your costs of camp? (Please list a dollar amount)
*
How much can your Troop contribute towards your costs of camp? (Please list a dollar amount)
*
How much financial assistance are you asking for with this scholarship? (Please list a dollar amount)
*
Please explain in detail your involvement in Girl Scouts:
*
Please explain in detail why you want to attend a Girl Scouts Camp?
*
Submit
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