Get documents about "2009 Girl Application for the South Carolina Girl Scout
Document Sample
2009 Girl Application for the
South Carolina Girl Scout Legislative Page Program
Please type or print clearly and legibly. Fill out application completely. Return completed application to:
Kim Neel, Legislative Page Program, PO Box 200, Irmo, SC 29063 by November 1, 2008 with the $5.00 application fee.
Girl’s Name: _____________________________________________________________________________________
(Last) (First) (Preferred name)
Home Address: (Street, Apt.#) (City) (Zipcode+4)
Present School Grade: Telephone Number: Email:___________________________________
(Best # to reach you. Area code and #) (for all correspondence – OK to list more than one)
Council Name: Troop/Group #: School: ______________________________
Please use an additional sheet of paper if necessary.
1. List any Girl Scout recognitions you have received in the last three years.
___________________________________________________________________________________________________________
2. List all of your extracurricular activities.
___________________________________________________________________________________________________________
3. List non-GS recognitions/ awards you have received since 8th grade not listed in above.
___________________________________________________________________________________________________________
4. List the name and date of all Destinations in which you have participated.
___________________________________________________________________________________________________________
5. List and briefly describe any training you have received through your Girl Scout Council or other community organization such as
Program Aide, L.I.T., First Aid certification, etc.
___________________________________________________________________________________________________________
6. List leadership roles/titles and the organization in the past 2 years.
___________________________________________________________________________________________________________
7. List your favorite service projects you have participated in during the past two years:
___________________________________________________________________________________________________________
8. Silver Award project summary (if earned):
___________________________________________________________________________________________________________
9. Gold Award project summary (if earned or if underway):
___________________________________________________________________________________________________________
Questions #10 and #11 are required information.
10. My House District Number is ____ Name of State House Representative: __________________________________________
11. My Senate District Number is ____Name of State Senator:______________________________________________________
If you do not know your representative or senator, go to http://www.scstatehouse.net/cgi-bin/zipcodesearch.exe and type in your zip code +4
12. Have you previously participated in the Girl Scout Page Program? No Yes
**********************************************************************************************************************************************************
Council Staff: I verify that the above named applicant is a registered member of GSUSA. I further recommend them to serve and know that
they will set a good example and uphold the Girl Scout Promise and Law.
Council Staff Signature___________________________________________________________Date__________________________
KZN 8.14.08 South Carolina Girl Scout Legislative Page Program Application – Page One of One
Related docs
