Juliette 2025 Fall Product Order Form

Juliette 2025 Fall Product Order Form

Please submit this form to acknowledge your participation and communicate important information needed by GSMW for product and reward delivery.
If you have not done so already, please submit your Caregiver Permission Form prior to submitting this order form.
Juliette Girl Scout Name*

First NameLast Name
Preferred Email Address*
example@example.com
Preferred Phone Number*
Please enter a valid phone number.
Shipping Address (UPS/FedEx - No PO Box)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address (USPS - PO Box)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How did your Juliette participate in the Fall Program?*

Paper Order Card
IMPORTANT: DO NOT include girl delivery orders taken online as they are already accounted for.

If you collect any online girl delivery orders between submitting this form and October 30th, those orders will be included in your product delivery.

Product received for the Fall Program is not rounded up to the next case, you will receive the exact quantity you need.

Quantity of Items on Paper Order Card - Please check for accuracy before moving onto the next section*

	Quantity
A. Mint Treasures with GS Tin
B. Caramel Apples
C. Cranberry Nut Mix
D. Cherry Almond Clusters
E. Dark Choc. Caramel Caps
F. Hot Cajun Crunch
G. Deluxe Pecan Clusters
H. Butter Toasted Peanuts
I. Nut & Caramel Trail Mix
J. Peanut Butter Bears
K. Peanut Butter Trail Mix
L. English Butter Toffee
M. Dill Pickle Flavored Peanuts
N. Chocolate Covered Almonds
O. Fruit Slices
P. Dulce De Leche Owls
Q. Care to Share Donations

Reward Selections

All rewards populate into M2OS based on the total sales by the girl. There are 2 reward levels with choices and one requires a t-shirt size. Please submit this information regardless of your Girl Scout's anticipated sales.
$550+ Combined Sales - Embrace Possibility T-Shirt*
$1800+ Combined Sales*

Build-A-Bear Kit$50 GSMW Gift Card
$2500+ Combined Sales*

Council Mini Backpack$75 GSMW Gift Card

Order Verification and Parent Responsibility
Verification*

I have reviewed the information above for accuracy and uploaded a picture of the paper order card(s), if applicable. I will check my email inbox for details regarding product and rewards pick/delivery and reminders during the Fall Program.
Signature*

Clear
Date*

MonthDayYear
Date
Name*

First NameLast Name
Please include any additional questions in the box below.
Should be Empty:

Paper Order Card