Girl Recruiter Eligibility Form
This patch is for girls who recruit NEW girl members to join Girl Scouts. To be considered a new member, the girl must not have ever been a Girl Scout OR not a member for the past two membership years. Patches and dangles will be mailed monthly. Questions? Please email recruitment@gsgatl.org
Girl Recruiter Name
*
First Name
Last Name
Girl Recruiter School
*
Girl Recruiter Grade
*
Please Select
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Girl Recruiter Pathway
*
Troop
Juliette
Summer Camp
Event/Program
Girl Recruiter Troop Number
*
Girl Recruiter Program Level
*
Please Select
Daisy
Brownie
Junior
Cadette
Senior
Ambassador
Girl Recruiter Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
I had fun making new friends while earning the
*
Girl Recruiter patch
Girl Recruiter dangle (1)
Girl Recruiter dangle (2)
New Girl Name #1
*
First Name
Last Name
New Girl School #1
*
New Girl Grade #1
*
Please Select
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Did you recruit another NEW girl?
*
Yes
No
New Girl Name #2
*
First Name
Last Name
New Girl School #2
*
New Girl Grade #2
*
Please Select
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Did you recruit another NEW girl?
*
Yes
No
New Girl Name #3
*
First Name
Last Name
New Girl School #3
*
New Girl Grade #3
*
Please Select
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Name of Requestor
*
First Name
Last Name
Email of Requestor
*
example@example.com
Phone Number of Requestor
*
Please enter a valid phone number.
Relationship to the Girl Recruiter
*
I am the Girl Recruiter
I am the caregiver
I am the Troop Leader
I am the Area Executive
Submit
Should be Empty: