Scholarship Request Form

Scholarship Request Form

This is the scholarship application for membership dues, uniforms, and event registration fees. Girl Scouting is open to children and adults, regardless of their ability to pay. To encourage participation in Girl Scout experiences, funds have been allocated to help those who request scholarship assistance. Fill out this form to request scholarship to pay membership dues for children and adults, uniforms and handbooks for children, or event/program fees for children.
I am requesting scholarship for the following:*

Membership DuesUniform or HandbookEvents/Programs
Applicant Information
Name of the Child or Adult Requesting Scholarship: *

First NameLast Name
What Grade or Age is this applicant in the Fall of 2025?*
What school does this child attend?
Is this applicant a new or returning member?*

New MemberReturning/Renewing MemberI Don't Know
What is the applicant's date of birth?

MonthDayYear
This is used to create a Girl Scout account in cases of new membership.
What is the applicant's Troop Number?
(If they do not have a troop number, please leave this field blank.)
Parent/Guardian or Adult Information
If you are applying for a child, what is the Parent/Guardian's Name?

First NameLast Name
What is the parent/guardian date of birth?

MonthDayYear
This is used to create a Girl Scout account in cases of new membership.
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County:*
Parent/Guardian or Adult Applicant Email:*
example@example.com
Parent/Guardian or Adult Applicant Phone:*
Please enter a valid phone number.
Demographic Information
Girl Scouts respects and welcomes people from all backgrounds and abilities. By completing the following information (as defined by the U.S. Census Bureau), you ensure support and funding for Girl Scouts in your community. Hispanic/Latina is defined as an ethnicity, not a race, and therefore is reported separately. This information is used for statistical purposes only.
Race of the applicant (Check All That Apply):

American Indian or Alaskan NativeAsianBlack or African AmericanHawaiian or Pacific IslanderWhiteI choose not to share at this timeOther
Ethnicity of the applicant:

Hispanic or Latino/aNon-HispanicI choose not to share at this time
Income Information
What is your annual household income?*
Total Number of Adults in Your Household:*
Total Number of Children in Your Household:*
Is there any other information you feel is important to share about your family's request for scholarship?
Membership Dues Request
What Membership Year are you requesting Membership Dues Scholarship for?*

Current Membership Year 2025 (October 1, 2024-September 30, 2025)Upcoming Membership Year 2026 (October 1, 2025-September 30, 2026)Extended Year - New Children/Adults Only (April 1, 2025-September 30, 2026)
Uniform Request
What Uniform Items are you requesting Scholarship for? (Check All That Apply)*

Tunic (Daisies) OR Sash (Brownie & up) - if a vest is preferred the family or troop is welcome to pay the difference in cost.American Flag PatchCouncil ID SetTroop Numbers/Juliette PatchMembership PinWorld Trefoil PinInsignia TabGirl Scout HandbookI already received the tunic/sash, flag & council ID at an event.None of the above.
Size of Tunic

S-M (6/7)L-XL (8/10)
Size of Sash

RegularExtra Long
*Earned awards, such as badges and petals, are not provided through Scholarship. Reimbursements will not be given for items that were purchased prior to or without an approval letter.
Event/Program Request
Name of the Event the applicant would like to attend:*
Event Location:*
Event Start Date:*

MonthDayYear
Date
Event Fee:*
Will the child's troop or family be contributing any amount to the total fee?

FamilyTroop
How much (including Badgerland Bucks) will the family be contributing?
How much will the troop be contributing?
Total amount requested in event/program scholarship:*
Optional Questions

Every year, Girl Scouts of Wisconsin – Badgerland receives financial assistance donations from various United Ways, individual donors and other foundations. If you choose to answer the questions below, your responses may be shared anonymously with potential donors. The following questions are not required and will not influence the financial decision.
Please share with us what this assistance would mean to your family and include a message of thanks that we can share with these generous sponsors.
Why have you chosen Girl Scouts for your child?
What impact has Girl Scouts made on your child's life?
Next Steps

Please allow 1-2 weeks for a Scholarship decision. An email will be sent to the troop co-leader and parent. If a request was approved for uniform items, a letter will be attached which can be printed and brought to a Badgerland Council Shop and redeemed for the approved items.
Should be Empty:

Scholarship Request Form

Applicant Information

Parent/Guardian or Adult Information

Demographic Information

Income Information

Membership Dues Request

Uniform Request

Event/Program Request

Optional Questions

Next Steps