Girl Membership
GIRL SCOUT MISSION
Girl Scouting builds girls of courage,
Join the global network of 3.2 million Girl Scouts
confidence, and character, who
Membership Year through 9/30/20
make the world a better place.
FUN WAYS TO PARTICIPATE :
Check one:
GSUSA ID (if known)
(check all that interest you)
Connect with nature.
Choose a camp by day or overnight.
Name: First
Middle
Last
Focus on half or full day
Address
Apartment
events to share your passions.
(
)
City
State / Zip Code
Girl Home Phone
Explore your interests
(
)
over a few sessions in a way that fits
Girl Cell Phone (only if 13 and older)
Girl E-Mail Address (only if 13 or older)
I wish to opt in:
your schedule.
Girl Scouts respects and welcomes people from all backgrounds and abilities. By completing the following information (as defined by the
Pack your bags. Travel
US Census), you ensure support and funding for girls in your community. Hispanic/Latina is defined as an ethnicity, not a race, therefore is
across town or around the world!
reported separately. This information is used for statistical purposes only.
Have fun on a regular
Date of birth: (mm/dd/yyyy)
/
/
# of years as a Girl Scout:
School grade in Fall 2013:
basis with your Girl Scout sisters.
Name of school:
Interact virtually with
Custodial care:
She is: (check all that apply)
She is Hispanic or Latina:
Household income:
Girl Scouts everywhere.
YES! I
would like to make a
I choose not to share
at this time
donation today that directly
benefits girls in our area. Enclosed
Other (please specify)
is my tax-deductible donation
I choose not to share
in the amount of: (check one)
at this time
Address is same as girl
Parent/Guardian (1) First Name
Middle
Last
PAYMENT INFORMATION:
Address
15
Membership Fee: $
Employer
Occupation
(
)
(
)
Donation: $
Home Phone
Business Phone
Total Attached: $
(
)
wish to opt in:
Cell Phone
E-mail Address
I
Address is same as girl
Parent/Guardian (2) First Name
Middle
Last
Address
Name on Credit Card
Employer
Occupation
(
)
(
)
Credit Card #
Home Phone
Business Phone
(
)
Cell Phone
E-mail Address
I wish to opt in:
Expiration Date
Media Permission
The Girl Scout Law
The Girl Scout Promise
When making the GS Promise,
Signature
When participating in Girl Scout
I will do my best to be
On my honor, I will try:
individual members may
activities I may be photographed
honest and fair,
To serve God and my country,
substitute wording appro-
for print, videotaped, or electronically
friendly and helpful,
To help people at all times,
priate to their own spiritual
Date
imaged. Images may be used in
considerate and caring,
And to live by the Girl Scout Law.
beliefs for the word “God.”
promotional materials, news releases,
courageous and strong, and
*Make checks payable to Girl Scouts
I/We acknowledge that the registrant will accept and
and other published formats for either
responsible for what I say and do,
abide by the Girl Scout Promise and Law. The registrant
the local Girl Scout Councils or Girl
and to
THANK YOU FOR
has permission to join Girl Scouts.
Scouts of the USA. The images will be
respect myself and others,
SUPPORTING GIRL SCOUTS!
the sole property of either the local Girl
respect authority,
Learn more about Girl Scouts at
Scout Council or Girl Scouts of the USA.
use resources wisely,
Signature of Parent/Guardian
Date
make the world a better place, and
be a sister to every Girl Scout.
Return this registration form,
Signature of Parent/Guardian
Date
along with GSUSA membership
fees to your local council. Fees
Council Code:
Service Unit/Team:
Group/Troop:
are non-refundable or transfer-
PATHWAY OF ENTRY:
able to another person.