Membership Pin Guard & Volunteer Pin Application

Girl Scout Membership Pin Guard and Volunteer Pin Application
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Service Unit Name
Cluster Name
Please indicate how you would like to receive your pin:
I was first registered at blanks Council.
Registered blank numbers of years as a Girl.
Registered numbers of years as an adult.
Please select which pin you are applying for:
Please share your favorite memory of being a registered Girl Scout/Volunteer:
You cannot apply for both pins in the same year; deadline is February 15th of each year. I am applyning for:
Membership Pin Guard (available in increments of 5)

Other
Volunteer Pin (available in increments of 10 years, after 20 year pin)

Other
Please upload your Girl Scout photo here!

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Girl Scout Membership Pin Guard and Volunteer Pin Application