Juliette Fund Request

Juliette Fund Request

This form is used to request funds earned by Individually Registered Girls through the council sponsored product programs.
The Juliette Fund is available for those Girl Scouts who have contributed to the fund through participating in Fall Product and Cookie Product Programs as an Independently Registered Girl. Applications should be submitted via the application below and can be used for membership registration fees, uniform items, retail purchases at our council Shop, La Tienda, program event fees, High Award programmatic expenses, and Girl Scout-related travel/Destinations programmatic fees. Juliette Funds may also be considered and used for the above expenses tied back to the parent/caregiver, as well. All requests must be Girl Scout-specific.

Approval is made on an on-going basis, and approval notifications are emailed to the parent/caregiver along with any Juliette Fund balance remaining in the Girl Scout's account. Use of funds will not be considered retroactively.
Girl Name*

First NameLast Name
Parent/Caregiver Email*
example@example.com
Girl Program Level
Parent/Caregiver Phone Number*
Please enter a valid phone number.
Reason for request*

Membership registration fee (girl) - $40Membership registration fee (adult) - $25Uniform item(s)Retail purchase at council ShopProgram event fee(s)High Award programmatic expenseGirl Scout-related travel/Destinations programmatic fee
If requesting a uniform item(s), please specify item(s) and estimated cost below.
If requesting an item(s) at the council Shop, please specify the item(s) and estimated cost below.
If requesting for a program event(s), please specify the event(s) below.
If requesting for a Girl Scout-related travel/Destinations, please specify the travel opportunity location below.
What product program has the Girl Scout participated in most recently?*

2023 MagNut Fall Product Program2024 Cookie Program
Please provide documentation related to the request, if applicable.

Cancelof
Signature of Parent/Caregiver*

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