2025 Juliette Cookie Program - Cookie Order Form

2025 Juliette Cookie Program - Cookie Order Form

Please submit this form to acknowledge your participation and communicate important information needed by GSMW for product and reward delivery.
If you have not done so already, please submit your Caregiver Permission Form prior to submitting this order form.
Juliette Girl Scout Name*

First NameLast Name
Juliette Caregiver Name*

First NameLast Name
Preferred Email Address*
example@example.com
Preferred Phone Number*
Please enter a valid phone number.
Phone Type
Shipping Address (UPS/FedEx - No PO Box)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address (USPS - PO Box)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Would you like your Juliette to be able to accept debit/credit card payments using the Clover Go App on a mobile device?*

YesNo
If yes, have you previously used the Clover Go App with a troop?*

YesNo
If yes, have you previously used the Clover Go App as a Juliette?*

YesNo
How did your Juliette participate in the Cookie Program?*
* Online Only Orders: please note that online girl delivery orders will be rounded up to the next case for each variety. There are 12 packages in each case.

Paper Order Card
Total Number of Packages on Paper Order Card

IMPORTANT: Please DO NOT include girl delivery orders taken online in the numbers below as they are already accounted for by GSMW.

Please note that your paper order card quantities listed below will be added to your online girl delivery orders, if any, and then rounded up to the next case for each variety. There are 12 packages in each case.

Cookies cannot be returned to GSMW.
I am ordering extra cookies for booths/fulfill additional orders taken. If yes, please write this information on your paper order card and add to your customer order totals. Please refer to the 2025 Cookie Program Guide for Juliettes. Please ensure that the picture of your order card includes this information. *
Donated Cookie Packages*
Adventurefuls Packages*
Toast-Yay Packages*
Lemonades Packages*
Trefoils Packages*
Thin Mints Packages*
Peanut Butter Patties Packages*
Caramel deLites Packages*
Peanut Butter Sandwich Packages*
Caramel Chocolate Chip - If you pre ordered Caramel Chocolate Chips, that quantity will be ordered for you. If you did not pre order any and received orders for them, please email Bridget at bridgetm@gsmw.org and GSMW will try to fulfill your request. .
Upload a clear picture/scan of order card(s) if used. Pictures need to include all of the customer orders and variety totals.

Cancelof

Order Verification and Caregiver Responsibility
Verification*

I have reviewed the information above for accuracy and uploaded a picture of the paper order card(s), if applicable. I will check my email inbox for details regarding product and rewards pick/delivery and reminders during the Cookie Program.
Signature*

Clear
Date*

MonthDayYear
Date
Name*

First NameLast Name
Please include any additional questions in the box below.
Should be Empty:

Paper Order Card