Share Your Service & Request Your Patch
As of 3/28/26, we no longer have any patches available. Thank you for your interest!
All submissions will be reviewed by a PSL Provisional Member. Form closes Friday, April 10. Patches will be mailed or scheduled for pick up after the form closes.
Name
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Email
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Phone Number
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How are you addressing elderly isolation in your community?
Purchased an item off the Amazon Wishlist
Mailing a card to the Woman's Club of Portsmouth (304 Sycamore Rd, Portsmouth, VA 23707)
Other (If selected, please give a detailed description on the next page.)
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If you purchased an item off the Amazon Wishlist, please let us know which item(s):
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Please give a detailed paragraph on how you are addressing elderly isolation in your community.
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Are you registered as a Girl Scout, Boy Scout, or other organization?
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Yes
No
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Please provide your troop number.
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Would you like to receive a patch?
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Yes
No
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How many patches are you requesting? (Only one per person. Troops are welcome to request patches for multiple people at once.)
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Are you local and able to pick up your patch at a designated time from the Woman's Club of Portsmouth?
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Yes (You will be contacted to schedule pick up)
No
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Mailing address
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If the Portsmouth Service League offers a patch opportunity in the future, would you like to be contacted?
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Yes
No
Submit
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