Request for Individually Registered Girl SU Funds
I have participated in a Girl Scouts of the Colonial Coast product sale program. All monies due and all required
paperwork were turned in to the service unit product sales coordinator or individual girl coordinator as directed.
Name: ________________________________________ Service Unit: ______________________________
Address: ________________________________________________________________________________
City: _______________________________________________ State: ___________ Zip: _______________
Phone: ___________________________________ Email: ________________________________________
I participated in:
Fall Product Sale (year: _____________)
Cookie Sale (year: _____________)
Service unit product program funds are intended for girl use only. It is recommended that funds be requested in
advance. To request reimbursement for items already purchased, attach receipts to this form. All items are
subject to review by the service unit individual girl coordinator before being reimbursed. Funds will be paid
directly to GSCCC or other approved vendor - no payment will be made directly to individual girls without
receipt for expenses. Funds may not be requested for expenses for parents, other girl members or for items
unrelated to Girl Scouting.
(Please list items. You may call the
Funds Requested For
Amount Requested
Other Information
shop to place your order and obtain a total amount.)
Membership Registration
$
Council Shop Purchase
$
Council Event
$
Bronze/Silver/Gold Project
$
Take Action Project
$
$
TOTAL Requested
Requested by: ______________________________________
Date: _____________________________
Signature of Individual Girl
Reviewed by Individual Girl Coordinator
Complete and return this form to the service unit
individual girl coordinator.
Please allow 7-10 days for processing.
Signature
Direct all questions to the service unit individual
Check # _______________________
girl coordinator.
Date Mailed: ___________________
Rev 05/2016 Program