Delinquent Parent Report Form

Delinquent Parent Report Form

Forms must be turned into Council no later than April 15 or the troop will be responsible for covering parents' outstanding balance.
To be used by the Troop Cookie Coordinator when a girl/parent owes cookie money to the troop.
Troop Number*
Service Unit*
Your Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Day Phone*
Please enter a valid phone number.
Eve Phone*
Please enter a valid phone number.
Use the space below to adequately describe any problem you have had in collection money due from the Cookie Sale Program. Please give as much information as you can in order to assist the council in collecting what is owed. Thank you for your assistance.
Youth's Name*

First NameLast Name
Parent's/Guardian's Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Day Phone*
Please enter a valid phone number.
Eve Phone*
Please enter a valid phone number.
Total # of packages recieved by youth*
Amount owed*
Amount Paid*
Balance Owed*
Description of attempts to collect*
The signed permission form and the signed receipt must also be included in order for the council to pursue the parents for payment of their cookie money owed.Would you like to... **

Upload the parent permission slip, receipts and any other documentation belowMail them no later than April 15 to:GSWIBCAttn: Customer Care4801 South Biltmore LaneMadison, WI 53718
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The Council retains the troop profit until the balance is paid in full.
Should be Empty: