JT Rev. 3/18
Activity Scholarship Application for Girls
Instructions (see detailed guidelines on next page)
1. Submit one application per girl per activity.
2. Allow a minimum of three weeks for processing.
3. Application must be completed entirely and signed by a parent or guardian to be considered.
4. Eligibility rules apply to all applications, see details on page 2
5. Contact the Answer Center with any questions at 314.400.4600 or answercenter@girlscoutsem.org.
1. Full name of girl: Current Grade:
City: State: Zip:
Day Phone: Evening Phone:
Adult Email:
Parent/Guardian Full Name Occupation Employer
Parent/Guardian Full Name Occupation Employer
3. Total People in Household: Ages of each Dependent Child in Family:
If you have other children applying for a scholarship, please list their names:
4. Please indicate which product programs the applicant has participated in within the last year:
Fall Product program Cookie program Neither, please explain:
5. Check the range of your total household gross income over the last year (include all sources of income, pre-
tax, such as employment, child support, unemployment, disability, social security, public assistance, etc.):
$0 - $19,999
$40,000 - $49,999
$70,000 - $79,999
$100,000 - $109,999
$20,000 - $29,999
$50,000 - $59,999
$80,000 - $89,999
$110,000 - $119,999
$30,000 - $39,999
$60,000 - $69,999
$90,000 - $99,999
Over 120,000
6. Last Girl Scouts of Eastern Missouri scholarship award received: Date: Amount:
7. Is there a special circumstance you would like us to consider when processing this request?
8. Activity for which a scholarship is being requested (a separate form is required for each activity):
Name of activity (program/camp/event):
Date(s) of activity:
Cost of activity or program: $
9. All scholarships require that a portion of the program cost be paid by the girl’s family and/or troop. Please
enclose the amount you can contribute at this time. You will be notified of your remaining balance due once
the scholarship award decision has been finalized.
Amount enclosed: $
Scholarship amount requested: $
Signature of Parent or Legal Guardian: Date:
For Office Use Only
Calc:____________ Amt Approved:$________________ Due:$________________ Date Due:________________ Emailed Task
Processing Staff Initials:________________ Approving Staff Initials:________________ Date:________________
click to sign
click to edit
Activity Scholarship Guidelines
Scholarships are not available for:
Adult participation in girl events
Awards or insignia
Books and materials
District or neighborhood travel
Out of Council Girl Scouts
Troop camping
Troop dues
Troop travel
Uniform items
4. Financial information
Scholarships are awarded on an individual basis based on family need, and are not designed to underwrite
event costs for an entire troop.
Award calculations are based on financial need and the Federal Poverty Level.
Scholarships are designed to supplement individual family resources, not replace them. A portion of the cost
must be paid by the girl’s family and/or troop. Any amount contributed allows us
to serve more girls.
Product programs help offset the costs of activity scholarships; girl participation will be taken into consideration
when awarding financial assistance.
Additional information may be required to process each request, potentially including a phone interview, proof
of income, and/or proof of dependents.
Scholarships are not retroactive; if payment was already received prior to scholarship application, the
scholarship will be nullified.
5. Submission instructions
Submit completed Activity Scholarship Application form with the activity registration form to the Girl Scout
Service Center, unless the following exceptions apply:
For district and neighborhood events, the scholarship application is sent to the Service Center, but the
program registration form must be sent to the event registrar (not Council).
For resident camps with a deposit, reserve the desired camp online (a $50 deposit is required), then
mail the Scholarship Application to the Girl Scouts of Eastern Missouri Service Center at address:
2300 Ball Drive, St. Louis, MO 63146. For resident camps with no deposit, the application should be
sent prior to payment.
6. Scholarship notification
Once a scholarship award decision has been finalized, the applicant will receive an email with the award
amount and amount still due, including a deadline for payment.
Any balance due must be paid by the deadline given, or the scholarship will be forfeited.
Contact the Answer Center at 314.400.4600 or answercenter@girlscoutsem.org with any questions
1. General information
Financial need-based scholarships are available for girls who do not have the funds to participate in a Girl
Scout program, to ensure that programs and camps are accessible to all girls.
Girl Scouts’ non-discrimination policy applies to the awarding of all Activity Scholarships.
All details concerning financial assistance requests are kept confidential.
2. Eligibility
The applicant must be a registered Girl Scout member in Girl Scouts of Eastern Missouri and accepted into a
program before activity scholarship application is considered.
Activity scholarships are only available for events or programs with registration fees of more than $10.
Applications must be received at the Girl Scout Service Center no later than the
program registration
Applications must be signed by the applicant’s parent or legal guardian.
Activity scholarships are non-transferable, valid only for the girl and specific program for which they are
Applicants and families with outstanding balances are not eligible for scholarship assistance until open
balances are paid.
All girls are subject to an activity scholarship maximum of $150 per year per Girl Scout for all programs and
camps except resident camp, council travel and destinations.
Resident camp: limited to one resident camp per girl per year.
Council travel programs: limited to one trip per girl per year.
destinations: limited to one destinations scholarship in a girl’s entire Girl Scout career. These
scholarship applications may require additional supplemental information.
3. Activity scholarships are available for registration fees for girl participants for the following:
Council sponsored programs and camps
District or Neighborhood events, within council jurisdiction
BS Rev. 7/20
SEL Rev. 2/20