Support Girl Scouts after the NorCal Fires

If your house was destroyed by the Northern California fires, Girl Scouts of Northern California (GSNorCal) is committed to replacing some of the Girl Scout items that you have lost. Any of our retail stores can support you through this process. Find your local store on our website by clicking here. Contact our Retail department by calling us on 800-447-4475 x 7090 or emailing us at shop@girlscoutsnorcal.org.

Requests will be filled on a first come, first served basis, up to the limit of the Opportunity Fund. Kindly submit one form per girl. In order to best serve you, if you have multiple girls, please call the shop in advance to let them know your items and arrival time.

Girl Scout Financial Aid Voucher

Girl's Name (enter N/A if not applicable): *

Adult Completing this Form: *

Role of Adult Completing this Form (i.e. troop leader, parent, etc.): *

Mailing Address of Adult Completing this Form: *

City: *

State: *

Zip Code: *

Phone: *

Email Address: *

Confirm Email Address: *

Troop #: *

Service Unit: *

Girl Items Needed: *

Please indicate level for Tunic/Vest/Sash: *

Please indicate size for Tunic: *

Please indicate size for Vest: *

Please indicate size for Sash: *

Please indicate size for Vest: *

Please specify up to 5 Earned Awards: *

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Troop Leader Items Needed: *

Insignia Tab w/ Pins (World Association & Girl Scout Membership)

Earned Awards

Girl's Guide Book

Journey Book(s)

Please specify up to 5 Earned Awards: *

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Please indicate level(s) for Girl's Guide Book: *

Journey Book(s) Title(s): *

Please choose your preference: *

Ship the items to my mailing address above

I will pick up the items at a GSNorcal retail store

Store location: *

Electronic Signature

Electronic Signature By typing my name on this form, I am entering my "electronic signature" (as defined in The California Uniform Electronic Transactions Act 1633.1 - 1633.17) and certifying that I have read, fully understand and accept all terms of this agreement.

Please type your full name here: *

Published November 25th, 2017

* Please Note: Once you submit this form, you'll have the option to print the form contents on the following page.