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Girl Scouts - Dakota Horizons :: SERVICE UNIT FUNDS APPLICATION
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* Indicates required question
Service Unit
*
Your answer
Community
*
Your answer
Request Date
*
Your answer
Program Date(s)
*
Your answer
Applicant Name
*
Your answer
Address
*
Your answer
City/ State/ Zip
*
Your answer
Phone Number
*
Your answer
Email Address
*
Your answer
Funds will be used for:
*
Retention
Recruitment
Program
Other:
Required
Describe planned activity in detail
*
Your answer
PROPOSED BUDGET
Item
*
Food & Beverage (served for programs)
Program & Supplies (Craft items, books, t-shirts, badges, etc.)
Office Supplies (Includes paper, pens, printer cartridges, printing services, markers, etc.)
Postage/ Shipping (Mailing costs for flyers or invites. Receipts must be kept and submitted.)
Financial Assistance (Girl/adult participants needing financial assistance.)
Rent (Facility and/or Equipment)
Other:
Estimated Cost
*
Your answer
Item
Food & Beverage (served for programs)
Program & Supplies (Craft items, books, t-shirts, badges, etc.)
Office Supplies (Includes paper, pens, printer cartridges, printing services, markers, etc.)
Postage/ Shipping (Mailing costs for flyers or invites. Receipts must be kept and submitted.)
Financial Assistance (Girl/adult participants needing financial assistance.)
Rent (Facility and/or Equipment)
Other:
Clear selection
Estimated Cost
Your answer
Item
Food & Beverage (served for programs)
Program & Supplies (Craft items, books, t-shirts, badges, etc.)
Office Supplies (Includes paper, pens, printer cartridges, printing services, markers, etc.)
Postage/ Shipping (Mailing costs for flyers or invites. Receipts must be kept and submitted.)
Financial Assistance (Girl/adult participants needing financial assistance.)
Rent (Facility and/or Equipment)
Other:
Clear selection
Estimated Cost
Your answer
Item
Food & Beverage (served for programs)
Program & Supplies (Craft items, books, t-shirts, badges, etc.)
Office Supplies (Includes paper, pens, printer cartridges, printing services, markers, etc.)
Postage/ Shipping (Mailing costs for flyers or invites. Receipts must be kept and submitted.)
Financial Assistance (Girl/adult participants needing financial assistance.)
Rent (Facility and/or Equipment)
Other:
Clear selection
Estimated Cost
Your answer
Total Estimated Cost
*
Please add estimated cost boxes together and enter total below
Your answer
Has the Program been held?
*
Yes (If yes, receipts must be submitted and approved before funds are dispersed)
No
Service Unit Manager's Name
*
Your answer
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