Year Pin Request Form
Requests must be received by March 31, 2026 to be provided in this membership year. Pins will be presented at the Volunteer Appreciation Dinners or through the service unit. These pin requests are for adult members only.
First Name
*
Pin Recipient
Last Name
*
Email Address
*
Pin Recipient
Phone Number
*
-
Area Code
Phone Number
Service Unit #
*
Membership Support Manager
*
Please Select
Caitlin McMonagle
Erica Raymond
Sarah Graham
Jensyn Burton Penta
Zekia Shoots
Maureen Hayden
Renee Rivera
Callista Carrier
Marnie Shaeffer
Leah Bardo
Becky Wright
I am eligible for and prefer to receive the following pin: (choose one)
*
Membership Numeral Guard
Volunteer Years of Service Award Pin
Cumulative years as a member of Girl Scouts
*
Please Select
5
10
15
20
25
30
35
40
45
50
55
60
65
70
75
80
85
Combined years of volunteer service (5 or more verifiable years)
*
Please Select
5
10
15
20
25
30
35
40
50
60
I am an adult member of GSNYPENN:
YES
NO
Do you plan to attend on of the Volunteer Appreciation Dinners?
Yes
No
Unsure
Submit Form
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