Girl Grant Application Form - Girl Scouts Of Northeastern New York
Download a blank fillable Girl Grant Application Form - Girl Scouts Of Northeastern New York in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Girl Grant Application Form - Girl Scouts Of Northeastern New York with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2For Office Use Only
Date Received _________ Date Scanned _________
___ Over $75___Under $75
Discount $_________ Committee Meeting _________
Amount Approved _________
8 Mountain View Avenue
Albany, New York 12205
518-489-8110 Office / 518-489-8065 Fax
GIRL GRANT APPLICATION
Girl Grants are available to Girl Scouts who otherwise cannot afford to register, purchase a uniform, or attend a program or summer camp. Fill out
the Girl Grant Application, using one form per girl. Applications will be considered as long as there are funds available. This form should be
submitted attached to the respective registration form. Provide as much information as possible to enable the volunteer selection committee to
make a fair decision. Once completed, submit this application along with the program registration form to the Albany Service Center. If this
request is for a summer camp program, please include a $25 non-refundable deposit. Only one week of summer camp will be considered. Any and
all Cookie Dough that a girl has earned will be applied prior to Girl Grant funds being applied. If the girl registrant is unable to attend the
program or camp, please notify the Registrars as soon as possible so that another girl registrant can be given the opportunity to attend the
program or benefit from a Girl Grant. This information will be seen only by authorized personnel for consideration in providing the Girl Grant.
***Only applications that are completed & signed by the parent (page 2) will be considered. Incomplete
applications will delay any girl grant decisions.***
Girl’s Name ________________________________ Date of Birth_____________ Grade (for camp, list grade entering in the fall)________
Mailing Address ______________________________________________ City ___________________ State __________ Zip ____________
Home Phone __________________________ County ____________________ # of Years in GS _____________________
Troop # ______Community/SU # ______ Grade Level:
Daisy
Brownie
Junior
Cadette
Senior
Ambassador
************************************************************************************************************
Age of each household member (adults and dependents) _________________________________________________________________________
Annual Gross Household Income Before Taxes
Household Salary
$
Alimony
$
SSI
$
Child Support
$
Food Stamps
$
Other
$
Do you participate in Federal School Meal Programs? No ____ Yes ____
If yes: Reduced _____ or Free ____
******************************************************************************************
Please describe the circumstances or financial situation that makes receiving the Girl Grant necessary.
________________________________________________________________________________________________
________________________________________________________________________________________________
Did you participate in the QSP program? ________________ Did you participate in the Cookie program? ____________
Are you applying for funding from another source? Yes __________ No _________
If yes, list the name of the: Organization ______________________________ Contact Person ________________ Phone # _________________
**Section 1: For Membership, Uniform/Insignia Merchandise, Programs under $75**
Please indicate the areas for which you are seeking assistance:
GSUSA Annual Membership Registration Fee
GSUSA Uniform/Insignia: DAISY
Daisy Tunic
Daisy Pin
Council ID
Troop #’s
BROWNIE
Brownie Sash
Brownie Pin
Council ID
Troop #’s
JUNIOR
Junior Sash
Junior GS Pin
Council ID
Troop #’s
CADETTE/SENIOR/AMBASSADOR
Teen Sash
Teen GS Pin
Council ID
Troop #s
Council Sponsored Program Under $75
Name of Program ____________________________________________________ Date of Program _________________
Fee for the Program ________________________ Amount being requested for the Program _______________________
ADVERTISEMENT
0 votes
Related Articles
Related forms
Supplemental Application Form - Apartments, Cooperatives & Condominiums - Greater New York Insurance Companies
Legal
Verbal Medication Consent Form And Log Of Administration - New York State Office Of Children And Family Services
Legal
Specialist Assistant Form 4 - Certification Of Experience - New York The State Education Department
Legal
Related Categories
Parent category: Business