Juliette Fund Disbursement Request
Council Name: Girl Scouts of Central & Southern NJ.

Important Note:  Girl Scouts of Central & Southern NJ will not reimburse for any expenses or items that are purchased or paid for out of pocket, except items purchased for Bronze, Silver or Gold Award projects.  In addition, any requests for adults including uniform components, gifts and accessories, adult membership registration or program events will not be honored.

If you have questions, please contact Customer Care at customercare@gscsnj.org

Form Updated 2/7/2022
Sign in to Google to save your progress. Learn more
Please allow a Minimum of 10 Business Days for processing.
Girl's Information
Girl's First Name *
Girl's Last Name *
Service Unit Name *
Girl's Member ID
Leave Blank if unknown.
Girl Scout Level *
Are you a currently registered member of Girl Scouts of Central & Southern NJ? *
I have participated in the following Product Program(s) as a Juliette: *
Check all that apply.
Contact Information
Parent/Guardian First Name *
Parent/Guardian Last Name *
Girl's Address *
City *
State *
Zip *
Cell Phone *
Parent/Guardian Email *
Clear form
Never submit passwords through Google Forms.
This form was created inside of Girl Scouts of Central & Southern NJ. Report Abuse