Membership Financial Assistance
Girl Scouts of West Central Florida is committed to ensuring every girl has the opportunity to participate in Girl Scouting. In order to join Girl Scout's, Girl's must be between the ages of 5-18 and must be starting Kindergarten in fall, through 12th grade. This form is for requesting financial assistance to cover the cost the $25 GSUSA Membership fee. Requests are granted based on financial need and funds available. Memberships are nontransferable and nonrefundable.
This section is for the parent/caregiver.
Caregiver's Name
*
First Name
Last Name
Caregiver's Date of Birth
*
-
Month
-
Day
Year
Date
Address of Caregiver
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Race
*
American Indian or Alaskan Native
Asian
Black or African American
Hawaiian or Pacific Islander
White
Other Race
I would rather not disclose
Gender
*
Female
Male
I would rather not disclose
Ethnicity
*
Hispanic
Non hispanic
I would rather not disclose
Email of Caregiver
*
Phone Number
*
Please enter a valid phone number.
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
Is the girl's address the same as the guardian address listed above?
*
Yes
No
Girl Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Race
*
American Indian or Alaskan Native
Asian
Black or African American
Hawaiian or Pacific Islander
White
Other Race
I would rather not disclose
Gender
*
Female
Male
I would rather not disclose
Ethnicity
*
Hispanic
Non hispanic
I would rather not disclose
Name of school girl attends
*
Troop Options
*
I know my Troop number
I want help in Finding a Troop
I want to participate in your Programs & Events
Troop Number
Girl's Grade as of 08/01/2024
*
Please Select
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Girl Scout Level (2024-2025 school year)
Daisy (K-1)
Brownie (2-3)
Junior (4-5)
Cadette (6-8)
Senior (9-10)
Ambassador (11-12)
Please explain any special circumstances and/or reason(s) for requesting financial assistance.
*
Submit
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