Membership Renewal Financial Assistance
Girl Scouts of West Central Florida is committed to ensuring every girl has the opportunity to participate in Girl Scouting. This form is for requesting financial assistance to cover the cost of Membership renewal fee. Requests are granted based on financial need and funds available.
Girl Information
This section is for the applicant, one per application
Girl's Name
*
First Name
Last Name
Girl's Date of Birth
*
-
Month
-
Day
Year
Date
Phone Number
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Troop #
# of Years as a Girl Scout
Girl's Grade as of 8/01/2025
*
Please Select
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Girl Scout Level (2025-2026 school year)
*
Daisy (K-1)
Brownie (2-3)
Junior (4-5)
Cadette (6-8)
Senior (9-10)
Ambassador (11-12)
Did your daughter participate in the 2025 Girl Scout Cookie Sale Program?
*
Yes
No
This section is for the parent/guardian.
A description of the section goes here.
Parent/Guardian Name
*
First Name
Last Name
Phone Number
*
Email
*
example@example.com
Please explain any special circumstances and/or reason(s) for requesting financial assistance.
*
Are you able to pay any portion of the Membership Fee? If so, please note below what you are able to help cover and we will be able to call you for a credit/debit card payment.
*
Submit
Should be Empty: