Community Service Bar Form

Community Service Bar

The Girl Scout Community Service Bar Awards are National Leadership Awards that recognize Girl Scouts who are making a difference in the community for a cause they care about - and practicing the values of the Girl Scout Law.
Girl Scout Cadettes, Seniors, and Ambassadors can earn this award once at each level.

To earn this award, you will choose a community organization to work with, receive instructions, and complete at least 20 hours of service.
Community Service Bars (Outside of Girl Scouting)

Examples: Volunteering at a veterinary hospital, soup kitchen, YMCA, day care, clothes drive, cemetery clean up, etc.

Each Service Bar requires 20 hours of service. Remember to obtain the required signitures. You must download and complete a Community Service Time Log before submitting this form.
Girl Scout's name:*

First NameLast Name
Girl Scout's email*
girl email or parent email
Troop leader's name:*

First NameLast Name
Leader's email:*
example@example.com
Troop Number:*
Phone Number*

Area CodePhone Number
Girl Scout Level:*

CadetteSeniorAmbassador
Which organization did you serve at?*
Supervisor's name:*

First NameLast Name
Supervisor's email*
example@example.com
Tell us about your volunteer experience. What did you do?*
What skills did you learn?*
What was the most impactful part of your experience?*
How many hours did you work?*
Upload your Community Service Log*

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A picture is worth a thousand words. Please feel free to share any pictures or supporting documentation here.

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I consent for the documents included to be utilized by GSWCF for the purpose of educational, advertising, non-commercial or commercial purposes in any manner or media whatsoever, including on the internet, in print campaigns, in-store and via television for either the local troop, by GSWCF or Girl Scouts of the USA(GSUSA). I hereby release and hold harmless the local troop, GSWCF, or GSUSA for any claim arising from the use of these images.*

Yes, let's celebrate!No, thank you.
I verify that everyone in the media provided has a signed photo release form.

Yes
Optional Demographic Survey

This is for data purposes only.
Which of the following best represent(s) your ethnic and/ or racial background(s)? Select all that apply.

Asian or Asian American (e.g., Chinese, Filipino, Japanese, Indian, Korean, Vietnamese, etc.)Black/Sub-Saharan African/African-American (e.g., Ethiopian, Haitian, Jamaican, Nigerian, etc.)Hispanic or Latino (e.g., Brazilian, Colombian, Cuban, Mexican, Puerto Rican, Salvadoran, etc.)Indigenous American or Alaska Native (e.g., Blackfeet Tribe, Inupiat Traditional Gov't., Navajo Nation, etc.)Middle Eastern or North African (e.g., Egyptian, Iranian, Israeli, Lebanese, Moroccan, Palestinian, etc.)Native Hawai`ian or Pacific Islander (e.g., Chamorro, Guamanian, Samoan, Tongan, etc.)White or European (e.g., British, French, German, Italian, Polish, Scandinavian, Spanish, etc.)Prefer not to sayOther
Do you identify with any of the following ability statuses? (Note: Ability status includes one's physical or mental ability to perform everyday tasks.) Select all that apply.

Attention deficitAutismBlind or visually impairedDeaf or hard of hearingHealth-related disabilityLearning disabilityMental health conditionMobility-related disabilitySpeech-related disabilityPrefer not to sayOther
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Community Service Bar

Girl Scout Cadettes, Seniors, and Ambassadors can earn this award once at each level.

Optional Demographic Survey