Intent to Earn Gold Award

Congratulations on your decision to take on the challenge of earning a Girl Scout Gold Award! By sending in this form, you are letting Girl Scouts–Arizona Cactus-Pine know you are making the commitment to pursue this prestigious award. This letter does not require you to earn the award; it only indicates your commitment to work toward earning this honor. This process requires many hours of planning and work. We are excited you have decided to Go Gold!

Before submitting this form, please check that you have met the following conditions:

I am at least in 9th grade.*

I have completed at least one of the following:*

Silver Award and One Senior/Ambassador Journey

Two Senior/Ambassador Journeys

I have learned about the Gold Award through at least one of the following:*

Select

If you selected other to the previous question, please describe how you learned about the Gold Award.

Gold Award Training Date (if applicable)

First Name*

Last Name*

What are your preferred pronouns?*

ex. she/her, they/them, etc.

Birth date*

Address*

City*

State*

Zip Code*

Email*

Parents Email*

Cell Phone

Home Phone

Best Way to Contact*

Select or enter value

Graduation Year*

Select or enter value

High School*

Troop Number*

Type IGM if no troop number

Service Unit*

Leader's Full Name*

Leader's Email*

Some possible issues or problems I want to address*

Any special concerns?

Send me a copy of my responses

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