The Rose Allen "Shorty’s" I Love Dark Hollow Day Camp Award
Rose Allen and her husband Jim (usually behind the scenes) were both long-time volunteers for Girl Scouts of Virginia Skyline Council. Rose spent over 35 years giving her time and talents, and she served as Neighborhood Registrar, Cookie Sale Chair, and Business Manager of Dark Hollow Day Camp. Shorty (Rose's camp name) touched the lives of thousands of girls and volunteers over the decades. She was one of the first inductees into our council's Hall of Fame and was awarded the illustrious Thanks Badge for her dedication.

To remember and honor Rose and to celebrate her Girl Scouting legacy, her family graciously and generously established the Rose Allen “Shorty” Scholarship Fund in 2011. This fund will be used to send up to 10 girls to Dark Hollow Day Camp each summer for 10 years! Per the family’s wishes, they would like leaders and those associated with Dark Hollow Day Camp to NOMINATE girls to receive a FULL SCHOLARSHIP.

(Criteria for submitting an application is not limited to financial needs.)

Email address *
Rose and Jim Allen
Instructions
- PLEASE APPLY EARLY – CAMP SPACES FILL FAST & SCHOLARSHIPS ARE LIMITED
- Please complete this form NO LATER THAN May 1, 2019
- Girl nominees must be a current Girl Scout member. Contact council at (540) 777-5100 or email info@gsvsc.org for confirmation.
- Nominators need to inform their nominee and parent / legal guardian so they don't register for camp prior to award distribution.
- Parents of the award recipients will complete the camp registration form and Health History Form online after being notified by Dark Hollow's Camp Registrar, Jinx Weary.
- Award recipients will be notified by Dark Hollow's Camp Registrar, Jinx Weary, and receive a special code to use during online registration. Nominators will also be notified by Jinx, but will not need to complete any other forms.
- Contact Jinx Weary with any additional questions: jcrie@cox.net
NOMINATOR INFORMATION
Your First & Last Name *
Your answer
Your Email *
Your answer
Your Phone Number *
Your answer
CAMPER NOMINEE INFORMATION
Girl's First & Last Name *
Your answer
Girl's Current Grade (as of 10/1/2018) *
Your answer
Is girl a current 2019 Girl Scout member? *
Girl's Troop Number (if applicable)
Your answer
Girl's Dark Hollow Camp Unit *
Girl's Parent or Legal Guardian - (NOTE: please be sure to notify the parent so they are aware and don't register for camp before finding out if their daughter is awarded the scholarship!) *
Your answer
Email of Parent or Legal Guardian *
Your answer
Phone Number of Parent or Legal Guardian *
Your answer
Address, City, State, Zip of Parent or Legal Guardian *
Your answer
NOMINATION
Why are you nominating this girl for a scholarship? *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of GSVSC. Report Abuse - Terms of Service