2018 Clean Sweep Patch & Certificate Request
Complete this form AFTER your cleanup. GROUP LEADERS -- BEFORE YOU BEGIN: Be sure you have the correct spelling for all individuals, and consider any tag-a-longs or other helpers (siblings, parents, friends) who are not official members of your group and whether the certificate should include the name of the group (example: brothers helping a Girl Scout troop).
Group Name *
As it should appear on the certificates, e.g. "Girl Scout Troop 363." If you are reporting as an individual, enter your own name
Your answer
Contact Name *
Your answer
Contact email
Your answer
Contact phone
Your answer
Address
Where we can send the certificates and/or patches
Your answer
Please check a preference *
Please list the name of each person who should receive a certificate (one person per line).
Groups may have some individuals who prefer not to have the group name on the certificate, like tag-a-longs or parents. Please indicate how these certificates should read.
Your answer
How many patches without certificates would you like?
Example: A Scout troop may want an extra patch for a scrap book, or some participants may want patches without certificates.
Your answer
Any other comments or special instructions?
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms