Membership Numerals and Volunteer Years of Service Recognitions Form

Membership Numerals and Volunteer Years of Service Recognitions Form

Use this form to submit a GSOFCT adult member or volunteer for their Membership Numeral Pin or Volunteer Year of Service Pin.
Submission Date*

MonthDayYear
Date
Nominee Information

Information for the adult member or volunteer you are submitting for recognition.
Nominee's Name*

Nominee's First NameNominee's Last Name
Nominee's Email Address*
example@example.com
Nominee's Troop Number *
Please enter the 5 digit troop # if not a member of a troop please enter 00000
Nominee's Service Unit Name*
Service Unit Name (if unsure of the SU please enter the town the nominee resides in)
What volunteer role(s) does the nominee currently hold, if any?*
Ie: Troop Co-Leader, Service Unit Manager, etc
Nominator Information

Membership Numerals and Volunteer Years of Service pins are the ONLY recognitions that volunteers may self nominate. Nominations can be submitted by anyone. This includes other GSOFCT volunteers, council staff, Girl Scout family members, Girl Scouts, and more. The person submitting the nomination does not need to be a registered member of GSOFCT.
Nominator's Name*

Nominator's First NameNominator's Last Name
Nominator's Email Address*
example@example.com
Nominator's Troop Number *
Please enter the 5 digit troop # if not a member of a troop please enter 00000
Nominator's Service Unit Name*
Service Unit Name (if unsure of the SU please enter the town the nominee resides in)

Nomination Details

Nominations are required for all recognitions, including membership and volunteer numeral pins. *Membership Years/Volunteer Years of Service for 20+ years submissions have closed for MY25 and will reopen on October 1, 2025.
Which GSUSA Numeral Pin are you nominating the volunteer for?*
Membership Numeral Pin

Description:
The Membership Numeral Pin recognizes the total years of registered membership in Girl Scouts at five-year intervals.

Criteria:
- The nominee is an active, registered adult Girl Scout for the duration being awarded. Membership years as a youth member plus years as an adult member are combined and counted toward this recognition pin.
*Membership Numerals 20 years & above are presented annually at the Recognitions Ceremony and Annual Meeting each spring. Membership Numerals under 20 years should be presented locally by the Service Unit or Troop.
Volunteer Years of Service Pin

Description:
The Volunteer Years of Service Pin recognizes an adult member registered with Girl Scouts of the USA for her/his years of active adult volunteer service at five-year intervals.

Criteria:
- The nominee is an active, registered adult Girl Scout VOLUNTEER for the duration being awarded.
*Volunteer Years of Service Pins 20 years & up are presented annually at the Recognitions Ceremoney and Annual Meeting each spring. Volunteer Years of Service Pins under 20 years should be presented locallly by the Service Unit or Troop.
Should be Empty:

Membership Numerals and Volunteer Years of Service Recognitions Form

Nominee Information

Nominator Information

Nomination Details