Program Information

Council-Sponsored Programs Financial Assistance
This form should be submitted as soon as you register for a program in gsEvents, but is due no later than 2 weeks prior to the program start date.

Girl Scouts can be awarded financial assistance for TWO Council-Sponsored programs per year in addition to being awarded financial assistance for summer camp and uniforms.
Girl Name*

First NameLast Name
Adult Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Date of Birth*

MonthDayYear
Date
County*
Troop Number
Name of Troop Leader*

First NameLast Name
Troop Leader E-mail
example@example.com
How long has your child been a Girl Scout (in years)?*

Program Information
Program Name*
Program Location*
Program Date*

MonthDayYear
Date
Are you registered for this program in gsEvents?*
You must be registered for your program in gsEvents and pay any applicable deposits in order to apply for financial assistance.
Program Fee*
How much will your family be able to contribute to this fee?*
How much financial assistance are you requesting for this program?*
Have you ever received financial assistance from GSMIDTN in this Girl Scout year (October 1, 2024 - September 30, 2025)*
What is your total household income?*

Below $10,000$10,000 - $19,999$20,000 - $29,999$30,000 - $39,000$40,000 - $49,999$50,000 - $59,999$60,000 - $75,000More than $75,000
How many people live in this household (adults and children)?*
What are the ages of any children living in this household?*
Describe any circumstances that explain your need and/or please include any information that you think we would find helpful.*
I certify that all of the information I have provided in this application are true. I understand that if I am awarded financial assistance and cancel my program registration outside of the cancellation window, that I risk losing the opportunity for other financial assistance this year.

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Council-Sponsored Programs Financial Assistance