Membership Pin Guard & Volunteer Pin Application

Girl Scout Membership Pin Guard and Volunteer Pin Application
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Service Unit Name
Cluster Name
Please indicate how you would like to receive your pin:

I would like to receive my pin at the Spring Awards Celebration (April) *Please send us a photo of you in your GS Uniform or attending a Girl Scout eventI would like my pin mailed to me
I was first registered at blanks Council.
Registered blank numbers of years as a Girl.
Registered numbers of years as an adult.
Please select which pin you are applying for:

Membership Pin Guard: Girl & Adult years as a registered member apply toward the Membership Pin Guard. The years do not have to be consecutive.Volunteer Pin: Adult volunteer years as a registered Girl Scout adult volunteer apply to the Volunteer Pin. The years do not have to be consecutive.
Please share your favorite memory of being a registered Girl Scout/Volunteer:
You cannot apply for both pins in the same year; deadline is February 15th of each year. I am applyning for:
Membership Pin Guard (available in increments of 5)

5 Year Pin10 Year Pin15 Year Pin20 Year PinOther
Volunteer Pin (available in increments of 10 years, after 20 year pin)

5 Year Pin10 Year Pin15 Year Pin20 Year PinOther
Please upload your Girl Scout photo here!

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Girl Scout Membership Pin Guard and Volunteer Pin Application