Form Pg320w - Council Wider Opportunity Trip Status And Troop Financial Assisstance Application Page 2
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1
2d. Cost of lodging (cost per person X # of participants)
$
e. Other costs (patches, insurance, emergency funds)
+ $
Total Cost for Troop/Group $
13.
Cost per person (
#
).
$
DIVIDE TOTAL COST FOR TROOP BY
OF PARTICIPANTS
14.
Basic Funding
A. Money saved for this trip BEFORE this current year.
A.
$
B. How much did the troop/group earn from the Fall Product Sale? _ ________
How much of this amount do you plan to use towards the total cost?
B.
$
C. How much did the troop/group earn from the Cookie Sale Program? _______
How much of this amount do you plan to use towards the total cost?
C.
$
D. Additional fundraisers planned:
Source
Amount
1.
2.
How much of this amount do you plan to use towards the total cost?
D.
$
E. Has the troop/group received any other source of monetary support?
Yes
No
If so, please describe the source:
E.
$
F. How much PERSONAL money is each person expected to pay toward Basic Costs?
Amount each GIRL will pay
$
X
(# of girls)
=$
Amount each ADULT will pay
$
X
(# of adults)
= $
Total amount of personal money from all girls and adults
F.
$
G. Total of Basic Funding (Add A, B, C, D, E, and F)
G.
$
15. Amount of Financial Assistance Requested:
H. Enter total trip cost for Troop/group (see # 12)
H.
$
I. Enter Total of Basic Funding (see line G from above)
I.
$
J. Balance (Subtract I from H)
J.
$
K. Amount of financial assistance requests*
K.
$
*Wider Opportunity Committee grants funding to qualified troops based on information provided, need, and availability of funding.
Basic guidelines for such grants are as follows: $5 for Daisies, $10 for Brownies, $15 for Juniors, and $20 for Teen Girl Scouts. Grants
will only be given to the number of registered adult participants needed to ensure Safety Activity Checkpoints girl/adult ratios are
met (see the Troop/Travel Camping guidelines).
If the total amount requested cannot be given will the trip be:
canceled
delayed/rescheduled
revised
other
Applicant Signature:
Name
Position
Date
Checklist:
Mail completed application and attachments:
Application fully completed and signed
Answers to questions 5 and 6 have been completed on a
Wider Opportunity Fund
separate sheet of paper and attached
Girl Scouts – North Carolina Coastal Pines
Attached photocopy of approved TP103
6901 Pinecrest Road
Attached list of participants
(program age level indicated)
Raleigh, NC 27613
Submitted according to deadlines listed below
Wider Opportunity and Financial Assistance Applications are due on or before the first of each month.
Applications received after the DUE date and applications that are up for reconsiderations will be considered at the
next meeting if applicable.
Requests for Council‐Sponsored events/trainings should be sent in at least three weeks prior to the event/training
with an event registration form and deposit.
Incomplete applications cannot be considered for funding. Lack of answers to questions #5 and #6 as well as a signed
TP‐103 will prevent your application from being considered until this information is received.
PG320W/6-17
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