Form Pg320w - Council Wider Opportunity Trip Status And Troop Financial Assisstance Application
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1
2Mail to:
Girl Scouts – North Carolina Coastal Pines
6901 Pinecrest Road, Raleigh, NC 27613
1‐919‐782‐3021 or 1‐800‐284‐4475
COUNCIL WIDER OPPORTUNITY TRIP STATUS AND TROOP FINANCIAL ASSISTANCE APPLICATION
INSTRUCTIONS: Complete this form if the TROOP is applying for Trip Status, planning a trip or participating in a council/area/county
event for which the TROOP needs financial assistance. Financial assistance is available to all registered troops and is awarded based on
information provided, need, and available funds. Troops must be granted Trip Status before financial assistance can be granted. Both
can be applied for at the same time. Use black ink or type. Applications for Wider Opportunity status and funding are due on the first
of every month.
Request:
Wider Op Trip Status*
Financial Assistance Date status given
* If “status” has been previously granted, please list approval date above. Troops may purchase Wider Opportunity patches upon
receiving approval letter.
1.
Troop Information (I
/
.)
NCLUDE ONLY THOSE INDIVIDUALS PARTICIPATING IN THIS SPECIFIC TRIP
EVENT
Troop/Group #
Grade Level
County/Area
Number of girls
How many girls at each grade level?
Number of adults registered
not registered
Please attach a list of all participants noting Girl Scout grade level for each participant.
2.
Contact Person:
Troop Leader
Event Director for Service Unit/Area Event
Name
Position
Address
City
Zip
Day Phone: (
)
Evening Phone (
)
Email Address:
3.
Event Title or Trip Destination:
4.
Dates of Event/Trip:
5.
Description of Event or Trip:
Please attach additional information on a separate sheet to give an overview of the event or trip. For trips, include a daily plan that
describes your program, lodging and transportation plans. Be as specific as possible. If it is an area or county event, attach the flyer
announcing the event.
6.
How does this event or trip enhance regular troop/group program. How were the girls involved
in planning for this event or trip? What fundraising activities were used? Please use a separate sheet.
7.
When did planning begin?
8.
Program and Safety Standards:
Has Safety‐Activity Checkpoints been read and used to plan program, including girl/adult ratio?
Yes
No
Has the “Trip/Travel Camping” section of Safety Activity Checkpoints been read and followed?
Yes
No
9.
Does your troop or members of your group owe money to Girl Scouts – North Carolina Coastal Pines?
Yes
No
If yes, please explain. ________________________________________________________________
10. Did your troop/group or is your troop/group currently participating in this year’s Fall Product Sale?
Yes
No
If no, please explain: _ __________________________________________________________
11. Did your Troop/Group or is your Troop/Group currently participating in this year’s Cookie Sale Program?
Yes
No
If no, please explain.
12. Financial Information: Please use actual information not estimates.
a. Total cost of transportation
$
b. Total cost of meals (cost per person X # of participants)
$
c. Total cost of program (cost of admission, tours, etc. per person X # of participants)
$
PG320W/6-17
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