Girl Scouts of Southern Nevada Scholarship Application MY2023

Girl Scouts of Southern Nevada Scholarship Application MY2023

For girls, the Girl Scout Scholarship covers a percentage of the membership fee, and basic uniform costs. Girl Scouts must participate in at least one product program and meet the requirements for a participation patch to qualify for additional scholarships. For adults, the Girl Scout Scholarship covers a percentage of the membership fee. Adults must take on a leader or service unit position to be eligible for a scholarship. Please ensure to complete the application in its entirety by adding the required documents and explanation of extenuating circumstances. Please note: The form must be completed by the parent/caregiver of girl applicants.

Membership Year*

Select

Membership Type*

Girl

Girl uniform only

Adult

Applicant First Name*

Applicant Last Name*

Applicant DOB*

Grade Level*

Select

School*

If you are applying for an adult scholarship, please put N/A.

Caregiver First Name*

Caregiver Last Name*

Caregiver DOB*

Email Address*

Phone Number*

Home Address*

Adult Role*

Adults must take on a Leader, Juliette Mentor or Service Unit Position to be eligible for a scholarship. If this is for a Girl Membership, please select "Girl Application"

Troop Leader

Service Unit Position

Juliette Mentor

Girl Application

Troop #*

You can search for a troop in your area by using this link: https://mygs.girlscouts.org/ If you are not able to find a troop, please contact our office for further assistance

Girl Scout Membership*

How many years have you been a member of Girl Scouts of Southern Nevada?

Select or enter value

Scholarship or Campership Received*

Have you received a membership scholarship ior campership in 2020-2021? Check the box below of the amount awarded below.

Select or enter value

GSSNV Financial Assistance*

Amount of Financial Assistance Received this year from GSSNV

Select or enter value

Number of Dependent Children Living at Home*

School Lunch Program*

Does your Girl Scout participate in the free/reduced lunch program? If yes, attach the 2021 - 2022 approved letter.

Select or enter value

File Attachments*

Please attach one of the following supporting documents in order for us to process your Financial Assistance Application: o A copy of your 2020 (or later) Tax Return (not W-2 forms) o A copy of your current TANF, SNAP, or Medicaid award letter o A copy of your Foster Child Custody letter

Drag and drop files here or

Extenuating Circumstance

Are there any extenuating circumstances that you believe make you eligible for a Girl Scout Scholarship? Documentation is required to support any extenuating circumstances & should be uploaded above.

By checking the box below & submitting this form, you agree to the terms listed at the top of this page*

Send me a copy of my responses

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