How to Redeem cookie Dough or Fall Sale Credits for Camp Fees

							                             Service Unit Reimbursement
                 Fall Sale/Cookie Reward Card for Camp or Event Fees
Service Units may receive Fall or Cookie Rewards from girls as payment for their camp or event fees. Please
accept these credits as you would money. The council will reimburse the total amount redeemed for your
camp/event fee for each girl submitting credits. Reward cards can not be used by adults.


1. Complete this form – all fields are mandatory:
                                                                               Card values can be checked at:
     Girls name – full name (first and last)                                      www.mercury-gift.com
     Fall or Cookie Reward Card Number – all 19 digits
     Note the amount of credit the girl is using. If she does not have enough credit, she can pay the balance
       with cash or check. The SU keeps any money collected as this form is only for the reimbursement from
       Girl Scouts of Northern California.
     Include a copy of the camp/event flyer or registration form.


2. Submit the camp/event flyer and this form to the council after the camp and only for those girls that did attend.
     Return the form to your area office: Girl Scouts of Northern California, Attn: Product Sales

South Bay/Peninsula Area         East Bay/Marin Area               N. Central Area          N. Coast Area
1310 South Bascom Ave.           7700 Edgewater Dr Ste.340         50 Landing Circle        4825 Old Redwood Hwy
San Jose, CA 95128               Oakland, CA 94621                 Chico, CA 95973          Santa Rosa, CA 95403
408-287-4170 ext 5005/5003       510-562-8470 ext 5007/5002        530-343-1904 ext5006 707-524-9210 ext 5004


3. Allow 4 weeks for processing. The reimbursement check will be sent directly to the person noted.


                               Product Sales Reward Redemption
Date:                   Total Reimbursement Requested: $
Contact Person:                               Phone #                      e-Mail:
Make Check Payable to:
           Mail Check to:
                  Address:
                       City:                                                         Zip:

                                 Fall or Cookie Reward                Event/Camp             Fall/Cookie Reward
Girls’ Name                      Card Number                          Registration Fee       Amount
                                                                      $                      $
                                                                      $                      $
                                                                      $                      $
Additional Space on                                                   Second Page            $
Back                                                                  Total
                                                                      Grand Total            $
              Product Sales Reward Card Redemption continued.

Girls’ Name          Fall or Cookie Reward Card   Event/Camp         Fall/Cookie Credit
                     Number                       Registration Fee   Amount




                                                  Page 2 Total       $