Uniform Financial Assistance

Uniform Financial Assistance Application

Your request will be processed within 10 business days.
Girl Scout Information
Girl's Name

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Regional Area
Troop Number
Date of Birth

MonthDayYear
Participant is a
How many years has your girl been in Girl Scouts?
Daisy uniforms include small tunic. Brownie–Ambassador uniforms include extra long sash. All levels include flag, troop numbers, council ID, insignia tab, and WAGGGS pin.
Which level is your Girl Scout?
Do you want a tunic/sash or vest?
Brownie Vest Size
Junior Vest Size
Cadette, Senior, and Ambassador Vest Size
If requesting a vest instead of a sash, you will need to pay the difference of $16.50. The Nashville Cabin will contact you to take your card number over the phone before your order is fufilled.
Family Information
Guardian Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Secondary Phone Number if Available
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Number of Children Living at Home
under the age of 18
Number of Dependents on Family Income
Ages
Total Annual Income
How much can you contribute to the uniform fee?
Income sources (check all that apply)

Other
Employer
Circumstances for Your Request
Please describe the circumstances that explain your assistance need

0/200
Have you ever received financial assistance from Girl Scouts of Middle Tennessee?
Guardian Signature
Date

MonthDayYear
Date
Should be Empty:

Uniform Financial Assistance Application

Girl Scout Information

Family Information

Circumstances for Your Request