IF A REGISTERED GIRL SCOUT LAST YEAR, DID CHILD PARTICIPATE
IN:
COOKIE SALE?
# OF BOXES SOLD?
QSP MAGAZINE & NUT SALE?
AMOUNT SOLD $
FATHER’S (GUARDIAN’S) NAME
OCCUPATION
MOTHER’S (GUARDIAN’S) NAME
OCCUPATION
FAMILY’S ANNUAL INCOME BRACKET:
Under $10,000
$10,000 - $15,000
$15,000 - $20,000
$20,000 - $25,000
$25,000 - $30,000
$30,000 - $35,000
Over $35,000
# of dependent children
in family
Names of sisters also applying
for assistance, if any:
Has your family received financial aid or campership assistance
from GSCGS, Inc. before?
Yes
No
If yes, please state year and amount
Please state extenuating circumstances, which might contribute to the need
for financial assistance. (i.e. medical expenses, support of aged family members,
etc.)
Please give the name of someone who knows you and your daughter. (Example:
Troop Leader, Teacher, Principal, Doctor, Clergyperson or School Nurse)