Download - Girl Scouts in the Heart of Pennsylvania

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Troop Roster Troop #____________________________________Service Unit #_______________________________ Girls First and Last Name Grade as of September 2012 Phone Number Emergency Contact Emergency Contact Phone Number Registered Adults Accompanying the Troop Adults Name Phone Number Role Emergency Contact Emergency Contact Phone Number Driver First Aider Chaperone Other Driver First Aider Chaperone Other Driver First Aider Chaperone Other Driver First Aider Chaperone Other Driver First Aider Chaperone Other Special Needs (Health, Physical, Dietary) ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 2012 Summer Camp – TAC Registration Form rev. 12/11 28
Financial Assistance Application Form Financial Assistance Request for: Day Camp/Troop Adventure Camp (Please circle) Adult /Girl /Troop Leader (Please circle one) Membership Year: 2011-2012 Important: Sections A and B must be completed in order to process the request. Incomplete forms will result in a processing delay. Allow four (4) to six (6) weeks for processing. Girls Scouts in the Heart of PA has a financial assistance fund to assist girls who might otherwise be unable to participate in Girl Scouting. Financial assistance is designed to supplement family resources, not replace them. Every attempt is made to grant the items requested however, there may be items denied due to funding constraints and/or eligibility issues. Financial assistance is granted only for the items listed on this form. All applications are confidential and only shared as necessary with appropriate staff members to determine eligibility for assistance. Mail completed form to: Girl Scouts in the Heart of Pennsylvania | ATTENTION: Financial Assistance Administrator | 350 Hale Avenue | Harrisburg, PA 17104 SECTION A – Girl or Adult Information-One Form per Applicant Name Address City State Zip Code ( ) Daytime Phone Email Address Service Unit Number County Position/Grade Level Troop Number Troop Leader Phone Number Leader’s Address City State Zip Code SECTION B – Family Information Applicant or Parent/Guardian Name Employed by Parent/Guardian Name Employed by ( ) Phone Title/Position ( ) Phone Title/Position Number of dependent children at home: Do your children receive subsidized school meals? Yes No Is your child(ren) home schooled? Yes No Gross Family Income (from your most recent tax return): $ Total number of persons dependent on Household Income Check all that apply toward household income: Unemployment SSI Disability Salaries 2012 Summer Camp - Financial Assistance Day Camp/Troop Adventure Camp Form Rev. 12/11 29 Child Support Other
Page 1 and 2: Summer Camp Guide 2012 Inspiring Ge
Page 3 and 4: Important Dates Table of Contents M
Page 5 and 6: Camp Furnace Hills Camp Furnace Hil
Page 7 and 8: General Information About Camp At G
Page 9 and 10: Ranch Camp At Ranch Camp, girls in
Page 11 and 12: 2012 Summer Camp - Sleep Away Camp
Page 13 and 14: FOR OFFICE USE ONLY Dates: Received
Page 15 and 16: Adventure Bound Calling All 9th - 1
Page 17 and 18: Adventure Bound Registration Form P
Page 19 and 20: Counselor in Training CIT I Program
Page 21 and 22: CIT Registration Form Please print
Page 23 and 24: Name of Resident Camps attended: (a
Page 25 and 26: Troop Adventure Camp Troop Adventur
Page 27: Troop Adventure Camp Form Please pr
Page 31 and 32: Check Out The Trading Post Whatever
Page 33 and 34: Family Camp Registration Form Pleas
Page 35 and 36: Frequently Asked Questions General
Page 37 and 38: Need Cookies? Find us on our new fr
Page 39 and 40: Day & Evening Camp Opportunities DE
Page 41 and 42: Columbia County Camp Louise Outdoor
Page 43 and 44: Lycoming County Camp Deepika Celebr

Download - Girl Scouts in the Heart of Pennsylvania

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