Leaves for Trained Volunteer Pin Form

Leaves for Trained Volunteer Pin Form
Trained Volunteer Pin Leaves can be earned as add-ons for the Volunteer Pin when additional enrichment trainings are completed.
Full Name*

First NameLast Name
Phone Number*
E-mail*
example@example.com
Service Unit Number*
Troop Number*
Girl Scout Volunteer Position*
Requested Pick Up Date*

MonthDayYear
Date
Please select a pick up option*

Pick up at Nashville Council officeMail to meGive to my Regional Executive
Address (if you selected "mail to me" on previous question)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Previous Awards:

The applicant has completed training in subject area(s) that have increased her/his skills in working with girls. Do not include courses needed for Trained Volunteer Pin. Minimum instruction time for each course is 10 hours.

Each green leaf represents one course of study with a minimum of at least ten contact hours of training. After receiving five green leaves, the recipient may replace them with one silver leaf. Five silver leaves may be replaced with one gold leaf.
Name of course
How course is used with girls/adults
Location
Date

MonthDayYear
Date
Number of hours of instruction
Name of course
How course is used with girls/adults
Location
Date

MonthDayYear
Date
Number of hours of instruction
Additional Courses (please include location, date, and hours)
If you are not a Service Unit team member, please list the contact information for a team member in your Service Unit. All Leaves for Trained Volunteer Pin applications must be approved by both the Service Unit and Council.
Service Unit Team Member

First NameLast Name
Service Unit Team Member Email
example@example.com
Signature*

Clear
Should be Empty:

If you are not a Service Unit team member, please list the contact information for a team member in your Service Unit. All Leaves for Trained Volunteer Pin applications must be approved by both the Service Unit and Council.