Program Financial Assistance Request
Dear Caregiver,

Girl Scouts is for every girl. As part of our dedication to investing in girls' leadership, our council makes funds available for girls and their families who need additional support in order to access council programs and opportunities. To apply for Financial Assistance, please fill out and submit the form below.

Assistance may be granted for half- or full-cost of program, and will not cover late registration fees, if applicable. All information provided is confidential. Your girl must be (or become) a registered Girl Scout to apply for Financial Assistance and to attend program. This form must be completed by a caregiver (troop leaders are not permitted to submit this form for troop members).

Requests will be reviewed weekly. Please submit one form per girl. Upon approval, a one-time use discount code will be issued via email provided in the form for the cost of the requested program. Complete event registration as usual and apply code at order summary. You will receive a confirmation email from Doubleknot when registration has been completed.

Questions? Please contact:

Girl Name (First Last) *
Your answer
Caregiver Name (First Last) *
Your answer
Troop Number (if in a troop) *
Your answer
Phone Number *
Your answer
Email *
Your answer
Girl's grade, as of today *
Please select reason(s) for financial need *
Does your girl qualify for free or reduced priced school lunches at school? *
Have you requested Financial Assistance in the past? Can include FA for Camp, Membership dues, uniform. *
Please identify the program and date girl is requesting assistance for: *
Your answer
Are you requesting assistance for half- or full-cost of program? *
Did your girl participate in the most recent cookie program? *
Name of person submitting *
Your answer
Relationship to girl: *
Your answer
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