Scoutship

*First Name:

*Last Name:

*Troop #:

Street:

City:

State:

*Zip Code:

Phone #:

By checking this box, I consent to receive customer care and account notification text messages (SMS or MMS) from Girl Scouts of Northeast Ohio. You may opt-out at any time by replying STOP. For assistance, text HELP. Message frequency varies. Message & Data rates may apply. View TERMS and TERMS

Grade

Note: Notification will only be sent to the email(s) listed below when the pending Scoutship application has been processed.

*Caregiver Email:

Troop Leader Email: (Troop Leader/Alternate email that would also receive notification)

*Program Year:

*Level:

*Total Annual Family Income: (Numbers Only)

*Total Number of Family Members in Household:

I am the applicant or the parent/guardian for the applicant and I verify that this information is accurate.
I am not the applicant or the parent or guardian for the applicant, but I have been granted permission by the applicant or the parent/guardian of the applicant to complete this information.

By agreeing and submitting this application you understand that Girl Scouts of North East Ohio may require documentation verifying the applicant’s annual family income. Documentation can include: W-2, proof of participation in the Free and Reduced Price School Meals program or proof of participation in Ohio Directions Card or EBT (Electronic Benefits Transfer) program.
I Agree

*Required Fields