Destination Pass Travel Scholarship Application

Guidelines:

• Applications are accepted on a rolling basis.
• Applicants must be a registered member of Girl Scouts of Hornets Nest Council.
Please type or print clearly. Incomplete applications may not be considered. All information is kept confidential.
Applicants will be notified via email regarding scholarship award decisions.
Girl Scots who are awarded travel scholarship funds are expected to share with their experience with others by: (1) Presenting at
council-sponsored events, and (2) Submitting photos and a brief overview essay for use in travel promotions.
• Photos and the essay are due no later than two weeks following the completion of travel.
• Please note that funding is limited, and not all applicants are guaranteed a scholarship. Up to five (5) travel scholarships of $800
each will be awarded. Parental involvement with Girl Scouts Hornets’ Nest Council will have no impact on award decisions or
funding amounts.
• Each Girl Scout may receive funding for one travel experience per fiscal year (January–December)
• Applicants must have sold a minimum of 48 boxes of cookies and one (1) Fall Product unit within the past year, or be actively
participating in the current travel scholarship cycle

Participant's Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

County:*

Troop #:*

Service Unit #: *

Email Address: *

example@example.com

Age:*

Grade:*

Years in Girl Scouting*

Cell Phone:

Please enter a valid phone number.

Home Phone:*

Please enter a valid phone number.

Parent/Guardian Full Name*

First NameLast Name

Leader's Full Name*

First NameLast Name

Has Girl Scout participated in the most recent:

Fall ProductCookie Season

# of units sold in Fall Product Program:

# of boxes sold in Cookie Season:

If no, please explain why:

Destination or Council Trip Title:*

Dates:*

Location:*

If applying for a Destination, is this your first time on a Destination?

YesNo

If not, what type of trip did you attend and where did you go?

If applying for a Council Trip, is this your first time on a Council Trip?

YesNo

If not, what type of trip did you attend and where did you go?

Have you received a scholarship for any other trips in the past?

YesNo

If so, how much and when?

Please check all awards you have earned as a Girl Scout:

Please list any non-Girl Scout Community Service projects you have been involved in.

Estimated Total Hours:

Total Fee as listed on GSUSA Website:

Estimated Travel Fee:

Total Fee:

Subtract non-refundable deposit:

Subtract Product Program Credits (if applicable)

Subtract amount family will pay:

Subtract amount participant will pay:

Subtract amount of money that will be contributed by your Troop:

Subtract amount of money that will be contributed by your Service Unit:

Total Remaining Cost:

Short Answer: Briefly describe your Girl Scout career:(Examples: camp, badges, journeys, events, Special Interest Groups, cookies, Council Programs, volunteering, Service Unit events, etc.)*

Girl Scout Travel Essay (To be completed by participant): In no more than 250 words, please describe how participating in this travel experience will positively impact your life, leadership growth, and personal development. Additionally, explain how you plan to share what you learn and experience with others when you return, such as through presentations, service, or council-sponsored events. *

Destination Pass Travel Scholarship Application

Event Information

Fees: