Girl Scout in School 25-26
Girl's Name - Nombre de nina
*
First Name
Last Name
Girl's Date of Birth
*
School Name - Escuela
*
Parent's Name
*
First Name
Last Name
Parent's Email Address
*
example@example.com
Grade
*
Teacher Name
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Please check all that apply
I've already sent in the $70 program fee or filled out form
I will pay the $70 program fee now
I can pay the partial payment of $45 & would like Financial Aid for the balance
I need full financial aid for my child
My child is in a Girl Scout Troop
Troop Number
My Products
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Registration
$70.00
$
70.00
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Partial Registration
$45.00
$
45.00
Quantity
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Full Financial Aid
Free
$
Free
Quantity
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Credit Card
Submit
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