fall 2013
a newsletter for girl scout daisies and brownies
just for fun... J T G F X Y H M E C U V A O L S A E I A M L R I A G M Z N N L D M A A L T H W D S A T Z N E S S O Y F
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Troop 70673 Earns Dinner with GSMH CEO Anne Soots Congratulations to Troop 70673 out of Sikeston! Their troop was drawn in the Troop Bucks drawing for “Dinner with the CEO.” Fourteen girls were in attendance and chose to have dinner at Lambert’s Café in Sikeston. The troop is very involved in the community and council, and loved doing neighborhood cookie booths which helped them sell 4,984 boxes of cookies. Congratulations on your success, girls!
E D A I S Y E B D S N U S X S L H R Z D
Can you find these words? Bee Brownie Candy Daisy Fall Family Friends Goals Magazine Nuts
Are You a 2013-2014 Registered Girl Scout? If not, be sure to re-register either online with ROSE at girlscoutsmoheartland.org/rose or by completing the form on page 12 and returning it to a service center near you!
Girl Scouts of the Missouri Heartland, Inc.
1 877-312-4764 • www.girlscoutsmoheartland.org • gscouts@girlscoutsmoheartland.org
september 2013–january 2014
DISCOVER new challenges in the world.
PROGRAM KEY Girl Scout Daisies Girl Scout Brownies Girl Scout Juniors
3, 2, 1...Blast Off!
All Girl Scouts Girl Scout Cadettes Girl Scout Seniors Girl Scout Ambassadors
T minus 10, 9, 8, 7, 6, 5, 4, 3, 2, 1...BLAST OFF! Spend the day being a NASA scientist. You will learn about rockets, build your own, and send them into outer space. You will make predictions on your rocket’s flight pattern, test its distances, and use your scientific brain to improve the rocket’s design. Register early or risk floating off into space. Each participant will get to build and keep her own rocket. We will tie in the It’s Your Story—Tell It! Journeys, and links will be sent home for further exploration. Please bring a sack lunch!
CONNECT through healthy relationships.
Troop Camping
If your troop is ready to go camping but needs a bit of “first-timer” help, then make this your destination. We’ll handle all of the planning and leading for the weekend. There will also be plenty of time for your troop to do their own thing! This weekend will be fun for first-time and experienced campers alike. OVERNIGHT!
Option 1: Friday Oct. 4–Saturday, Oct. 5, 2013 Time: 6:00 p.m. Friday–4:00 p.m. Saturday Location: Finbrooke Progam Center Registration Deadline: 9/20/13 MIN/MAX: 40/100 Girl Cost: $20.00 Adult Cost: $20.00
Option 2: Sunday, Oct. 6, 2013, 12:00 p.m.–5:00 p.m. Location: Jefferson City, MO Registration Deadline: 9/20/13 MIN/MAX: 25/100 Girl Cost: $15.00 Adult Cost: Free to observe
OVERNIGHT!
Option 2: Friday, April 25–Saturday, April 26, 2014 Time: 6:00 p.m. Friday–4:00 p.m. Saturday Location: Latonka Program Center Registration Deadline: 4/16/14 MIN/MAX: 40/100 Girl Cost: $20.00 Adult Cost: $20.00
DISCOVER practical life skills.
OVERNIGHT!
Option 1: Saturday, Oct. 5, 2013, 10:00 a.m.–3:00 p.m. Location: Silver Meadows Program Center Registration Deadline: 9/20/13 MIN/MAX: 25/100 Girl Cost: $15.00 Adult Cost: Free to observe
Option 3: Friday, June 13–Saturday June 14, 2014 Time: 6:00 p.m. Friday–4:00 p.m. Saturday Location: Silver Meadows Program Center Registration Deadline: 5/30/14 MIN/MAX: 40/100 Girl Cost: $20.00 Adult Cost: $20.00
Brownies in the Woods
Are you ready for an adventure with your Girl Scout Brownie friends as you earn the Hiker badge? You’ll learn some hiking tips, pack your own snack and then hit the trails for a nature hike. Who knows what kinds of exciting things you will discover in the woods! Price includes a snack and the Hiker badge. Bring a sack lunch and your water bottle. Option 1: Saturday, Oct. 12, 2013, 10:00 a.m.–3:00 p.m. Location: Mintahama Program Center Registration Deadline: 9/27/13 MIN/MAX: 20/100 Girl Cost: $8.00 Adult Cost: $2.00
! T E G R O F T ’ DON
Option 2: Saturday, April 5, 2014, 10:00 a.m.–3:00 p.m. Location: Finbrooke Program Center Registration Deadline: 3/21/14 MIN/MAX: 20/100 Girl Cost: $8.00 Adult Cost: $2.00 Option 3: Saturday, April 26, 2014, 10:00 a.m.–3:00 p.m. Location: Latonka Program Center Registration Deadline: 4/11/14 MIN/MAX: 20/100 Girl Cost: $8.00 Adult Cost: $2.00
You can use Girl Scout Cookie Credit gift cards to pay for your event registration fees!
Option 4: Saturday, April 26, 2014, 10:00 a.m.–3:00 p.m. Location: Silver Meadows Program Center Registration Deadline: 4/11/14 MIN/MAX: 20/100 Girl Cost: $8.00 Adult Cost: $2.00
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DISCOVER a strong sense of self.
Kaleidoscope
DISCOVER a strong sense of self.
Are you ready to splash on a bold stroke of color? You will discover what it is like to get creative and make your own masterpiece. We’re even going to learn about colors and participate in a fun “choose your favorite color” activity. Be sure the to wear clothes you can get paint on—art can be messy! We’ll be working on the Brownie Painting badge and Zinni’s Art of Sharing Daisy Petal.
Horse Tails
Get to know the council horses at this program. You will learn about horse safety, grooming, and receive a horseback riding arena lesson. Before the day is over you will participate in a “Showdeo” and be able to show off all the new things you’ve learned! Fee includes horseback riding instruction and a participation patch.
Date/Time: Saturday, Oct. 5, 2013, 9:00 a.m.–12:00 p.m. Location: Poplar Bluff, MO Registration Deadline: 9/20/13 MIN/MAX: 20/150 Girl Cost: $10.00 Adult Cost: Free to observe
Date/Time: Saturday, Nov. 9, 2013, 8:30 a.m.–4:30 p.m. Location: Sacajewea East Program Center Registration Deadline: 10/24/13 MIN/MAX: 10/40 Girl Cost: $40.00 Adult Cost: Free to observe
CONNECT through cooperation & team-building.
CONNECT through cooperation & team-building.
Sports Lock-in at Missouri State University
Tabletown
Come together with others and plan what an ideal community looks like for a night using tables, sheets, blankets, and more. Explore new ways of living in our world sustainably. The value of common ground, respecting other’s ideas, and working together come to life in this fun, creative, overnight event that introduces what it means to be part of a camp community. We will spend the night exploring the Brownie Quest Journey. A patch and continental breakfast is included. Bring your own box dinner. Participants will be sent home with a summary of what parts of the Journey were completed.
OVERNIGHT!
Come cheer the MSU Lady Bears Volleyball team on to victory and then spend the night at Hammons Student Center experiencing a wide variety of sports. You will get a private autograph session with the Lady Bears and then earn parts of the athlete-themed badges for each age level. The rest of the night will be spent playing volleyball, basketball, racquetball, and other games with Girl Scouts from all over the council. End the night watching a movie. Cost for girls includes a patch. Troops can bring their own snacks and breakfast.
Option 1: Friday, Nov. 22, 2013, 7:00 p.m.–8:00 a.m. Location: Sedalia, MO Registration Deadline: 11/08/13 MIN/MAX: 25/100 Girl Cost: $15.00 Adult Cost: $10.00
Date: Friday, Nov. 8–Saturday, Nov. 9, 2013 Time: 7:00 p.m. Friday–8:00 a.m. Saturday Location: Missouri State University, Springfield Registration Deadline: 10/25/13 MIN/MAX: 100/250 Girl Cost: $12.00 Adult Cost: $8.00
Option 2: Friday, Dec. 13, 2013, 7:00 p.m.–8:00 a.m. Location: Lake of the Ozarks, MO Registration Deadline: 11/29/13 MIN/MAX: 25/100 Girl Cost: $15.00 Adult Cost: $10.00
CONNECT through cooperation & team-building.
Snack-tastic
Join us for a fun afternoon in the kitchen as we make some treats and work on earning some badges! The dietitian from Hy-Vee grocery stores will teach you how to make a yummy snack and how to make sure and eat healthy. And of course, you will get to eat the snacks you make! Daisies will earn part of their Respect Myself and Others petal; Brownies will earn part of the Snack badge, and Juniors earn part of the Simple Meals badge. Price includes snacks for girls and adults.
A NOTE TO PARENTS...
Age Note: Option 1 is for Juniors and Option 2 is for Daisies and Brownies. Date: Saturday, Nov. 9, 2013 Option 1: (Juniors) 10:00 a.m.–11:00 a.m. Option 2: (Daisies and Brownies) 12:00 p.m.–1:30 p.m. Location: Finbrooke Program Center Registration Deadline: 10/25/13 MIN/MAX: 20/100 Girl Cost: $12.00 Adult Cost: $4.00
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Many Girl Scout troops register to attend programs as a group, but girls may attend any program for their age level as an individual (adult chaperone required). We encourage you to look through these listings with your Girl Scout and talk to her about the programs she’d like to attend. The Event Registration Form can be found on pages 13-14 and online in the Forms section of girlscoutsmoheartland.org. If you have questions about any of the program listings, please email programs@girlscoutsmoheartland.org or call 877-312-4764 to speak with a leadership and learning specialist.
DISCOVER positive values.
Paper Dolls Galore!
Do you know someone that used to be a Girl Scout? Have you ever heard them talking about how their uniform used to look? We’ll travel back to the 1900s and learn some Girl Scout history along the way. Through paper dolls, games, and other activities, we will get a chance to travel through time to see how Girl Scouts was different, or the same, as it is today.
DISCOVER practical life skills.
Better Than A Band-Aid
Can a band-aid make everything better? It can sure help! But it’s even better to be safe first. We’ll have some very important people such as police officers, fire officers, and healthcare experts teach you what to do to stay safe and how to handle it when things go wrong. You will earn the First Aid badge while preparing for emergencies.
Option 1: Saturday, Jan. 11, 2014, 9:00 a.m.–11:00 a.m. Location: Silver Meadows Program Center Registration Deadline: 12/20/13 MIN/MAX: 20/100 Girl Cost: $10.00 Adult Cost: Free to observe
Date/Time: Saturday, December 7, 2013, 1:00 p.m.–4:00 p.m. Location: Sikeston, MO Registration Deadline: 11/22/13 MIN/MAX: 20/150 Girl Cost: $9.00 Adult Cost: Free to observe
Option 2: Saturday, Jan. 11, 2014, 2:00 p.m.–4:00 p.m. Location: Boonville, MO Registration Deadline: 12/20/13 MIN/MAX: 20/100 Girl Cost: $10.00 Adult Cost: Free to observe
CONNECT with your local community.
Theater Day at Missouri Southern State University
Option 3: Sunday, Jan. 12, 2014, 1:00 p.m.–3:00 p.m. Location: Eldon, MO Registration Deadline: 12/20/13 MIN/MAX: 20/100 Girl Cost: $10.00 Adult Cost: Free to observe
Have you ever dreamed of being an actress or wondered what happens behind the scenes of a play? Join sister Girl Scouts at the MSSU campus as theater students and professors guide you through a day exploring theater! You will participate in theater games and activities and get a behind the scenes tour of the theater including props and costumes. Best of all, you’ll end the day watching a live performance of a children’s play! The day will include activities that count toward completion of the It’s Your Story—Tell it! Journey for each age level. Girl price includes a patch. Participants will need to bring a sack lunch.
Option 4: Saturday, Feb. 1, 2014, 9:00 a.m.–11:00 a.m. Location: Joplin, MO Registration Deadline: 1/17/14 MIN/MAX: 20/100 Girl Cost: $10.00 Adult Cost: Free to observe Option 5: Saturday, Feb. 1, 2014, 2:00 p.m.–4:00 p.m. Location: Pittsburg, KS Registration Deadline: 1/17/14 MIN/MAX: 20/100 Girl Cost: $10.00 Adult Cost: Free to observe Option 6: Saturday, Feb. 8, 2014, 10:00 a.m.–12:00 p.m. Location: Finbrooke Program Center Registration Deadline: 1/24/14 MIN/MAX: 20/100 Girl Cost: $10.00 Adult Cost: Free to observe
Date/Time: Saturday, Dec. 7, 2013, 10:00 a.m.–4:00 p.m. Location: Missouri Southern State University Campus, Joplin Registration Deadline: 11/20/13 MIN/MAX: 20/100 Girl Cost: $6.00 Adult Cost: $2.00
Option 7: Saturday, March 8, 2014, 10:00 a.m.–12:00 p.m. Location: Dexter, MO Registration Deadline: 2/21/14 MIN/MAX: 15/100 Girl Cost: $10.00 Adult Cost: Free to observe
DISCOVER practical life skills.
Leaves of Green
Daisies need green leaves in order to thrive, and people need their own kinds of green leaves to get by—money! Earn the Money Counts Financial Literacy petal in an interactive Children’s museum, the Bootheel Youth Museum in Malden, or the Discovery Playhouse in Cape Girardeau. After a fun banking and shopping experience, explore the other exhibits in the museum. Option 1: Saturday, Dec. 14, 2013, 10:00 a.m.–12:00 p.m. Location: Cape Girardeau, MO Registration Deadline: 12/04/13 MIN/MAX: 15/100 Girl Cost: $8.00 Adult Cost: $2.00 Option 2: Saturday, Jan. 11, 2014, 10:00 a.m.–12:00 p.m. Location: Malden, MO Registration Deadline: 1/03/14 MIN/MAX: 15/100 Girl Cost: $8.00 Adult Cost: $2.00
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The fall product program is a great way to get a head start on learning business skills like teamwork and goalsetting , and for troops to earn proceeds earlier in the school year. There are two types of products sold during this program—magazines, and nut and chocolate items (check out the yummy selection below). This year’s theme is “Be Your Best You,” and the mascot is the bee. The program is for friends and family and runs November 1-17. Check with your troop leader for more details. Take a look at a SNEAK PEEK of this year’s awesome recognition items on the next page!
2013 Fall Product Program line-up $6.00 Peanut Butter Bears Honey Roasted Peanuts Salsa Mix Butter Toasted Peanuts Chocolate Covered Peanuts Dark Chocolate Covered Pretzels Deluxe Pecan Clusters NEW! Fruit Slices NEW! Dulce de Leche Owls NEW! Dark Chocolate Mint Penguins $7.00
daisies & brownies: By participating in the Fall Product Program, you learn important skills you will need to become a successful leader in the future. These skills include:
• goal setting • decision making • money management • people skills • business ethics
Whole Cashews Chocolate Covered Raisins
$8.00 NOW! Caramel Treasures in a Girl Scout tin Chocolate Covered Pretzels in a special tin
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2013 magazine recognition items
2 Magazine Items • “Be Your Best You” Patch
4 Magazine Items • Tapefitti OR • Stickerzine Album
6 Magazine Items • Plush Bee OR • Fancy Nail Design Set
10 Magazine Items • T-Shirt Design Kit OR • Theme Bag
15 Magazine Items • Glitter Tattoo Body Art Set OR • Wrist Rox Bracelet Kit
8 Magazine Items • Mag Super Seller Patch
interlocking patches 2013-14 Patch 1 completed address book Online Patch 12 or more online email addresses
Be Your Best Patch 2 magazine items Share Patch 5 or more donation orders to Project Thank You
Grow Patch 10 nut/ chocolate items
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about recognition items...
To celebrate your achievement, you earn recognition items in this program. Items are earned based on different sales goals, for both magazine items and nut and chocolate items. Recognitions are cumulative—so whatever goal level you meet, you’ll receive the items at that level AND all the levels below it! For example, if you sell 6 magazine items, you’ll earn: the plush bee (or fancy nail design set—your choice) AND the tapefitti (or stickerzine album—your choice) and the “Be Your Best You” patch.
2013 nut/chocolate recognition items
10 Nut/Chocolate Items • “Grow” Patch
20 Nut/Chocolate Items • Tapefitti OR • Stickerzine Album
15 Nut/Chocolate Items • Eraser Toppers OR • Collapsible Water Bottle
25 Nut/Chocolate Items • “Believe” Charm Necklace
40 Nut/Chocolate Items • Super Seller Patch
30 Nut/Chocolate Items • Color Me Pouch OR • Fancy Nail Design Set
50 Nut/Chocolate Items • T-Shirt Design Kit OR • Theme Bag
2013 bonus levels
$500 Combined Sales • Large Plush Bee
$600 Combined Sales • Mini Locker OR • Book Certificate (300 Piece Fashion Paper Doll Set available on book certificate)
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75 Nut/Chocolate Items • Glitter Tattoo Body Art Set OR • Wrist Rox Bracelet Kit
$700 Combined Sales • Paillette Sequined 17” Lamp AND Goal Achiever Patch
Summer Camp 2013 Girl Scouts of the Missouri Heartland offered 6 weeks of resident camp at 4 different program centers across the council. Girls chose from a wide variety of sessions, including ones that emphasized swimming, horseback riding, robotics, challenge courses, basic outdoor fun, and more! Camp provides a unique opportunity for girls to learn traditions of Girl Scouts while also providing a safe, relaxed environment where girls feel free to try new things. Days begin and end with a flag ceremony, meals start only after grace, and everyone has Kapers they must complete. In between the swimming, horseback riding, archery, hiking, game playing, song-singing and craft-making, girls find time to relax with a good book, write a letter home to their family, or take a short siesta in the shade. Every day at camp provides girls with an opportunity to make new friends, challenge themselves by trying something new and, most of all, to make memories that will last a lifetime. 8
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shopwith us!
Visit our retail shops located in each of our service centers to find the latest in Girl Scout wear, program books, patches, awards, jewelry, gifts, and more! Don’t forget to get your Journeys and Girl’s Guides while you’re there! Every girl deserves her own!
NEW! Official Brownie and Daisy Shorthand Polos!
Girl Scouts of the Missouri Heartland retail shops have everything you need! Girl Scout Cookie Credit can be used at any GSMH retail shop, or applied to mail or phone orders.* *Please note: Girl Scout Cookie Credit may only be spent by the girl who has earned it.
Shop online at girlscoutsmoheartland. org or complete and send us a Retail Shop Mail-Order Form found on page 15 to shop by mail. Shops are open 8:30 a.m.–4:30 p.m., Monday–Friday (closed 1:00–2:00 pm, except Springfield). Check our website for current Saturday hours.
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WITH
STARTE ERY R EV
A
KIT
GET STARTED THIS YEAR WITH A STARTER KIT. FOR NEW AND BRIDGING GIRL SCOUTS!
FREE BAG ! A $12 VALUE
Tear out this page and use it with our Retail Shop Mail-Order Form to order a Starter Kit today!
• Tunic* $58.50 or Vest* $60.25 • Flag Patch • GSUSA ID Set • Troop Numerals (5)
• Sash* $50.00 or Vest* $61.25 • Flag Patch • GSUSA ID Set • Troop Numerals (5)
• Sash* $51.00 or Vest* $61.75 • Flag Patch • GSUSA ID Set • Troop Numerals (5)
• Insignia Tab • Insignia Tab • Insignia Tab • Girl’s Guide • Girl’s Guide • Girl’s Guide • Journey Book (choose 1) • Journey Book (choose 1) • Journey Book (choose 1) Daisy Flower Garden Between Earth & Sky 3 Cheers for Animals
Brownie Quest Wonders of Water World of Girls
• Sash $51.50 • Insignia Tab or Vest $66.50 • Girl’s Guide • Journey Book (choose 1) • Flag Patch • GSUSA ID Set Amaze GirlTopia • Troop Numerals (5) Breathe Sow What? MEdia
Mission: Sisterhood
Agent of Change Get Moving aMuse
Your Voice/World Justice Bliss: Live It/Give It
*Additional cost for plus size
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Girl Membership
Join the global network of 3.2 million Girl Scouts Membership Year through 9/30/20 Please complete this form in its entirety.
DeMoGrapHicS
Girl inForMation
check one:
� New Member
� Renewing Member
Name: First
(check all that interest you)
Middle
� camp: Connect with nature. Choose a camp by day or overnight.
Last
Address
� events: Focus on half or full day events to share your passions.
Apartment
City
State / Zip Code
( ) Girl Home Phone
( ) Girl Cell Phone (only if 13 and older)
Girl E-Mail Address (only if 13 or older)
i wish to opt in: � Texts � E-mails
� Series: Explore your interests over a few sessions in a way that fits your schedule.
Girl Scouts respects and welcomes people from all backgrounds and abilities. By completing the following information (as defined by the US Census), you ensure support and funding for girls in your community. Hispanic/Latina is defined as an ethnicity, not a race, therefore is reported separately. This information is used for statistical purposes only.
� travel: Pack your bags. Travel across town or around the world!
Date of birth: (mm/dd/yyyy)
� troop: Have fun on a regular basis with your Girl Scout sisters.
/
/
# of years as a Girl Scout:
School grade in Fall 2013:
name of school: custodial care: � Both Parents � Mother/Guardian Only � Father/Guardian Only � Other
She is: (check all that apply) � American Indian or Alaskan Native � Asian � Black or African American � Hawaiian or Pacific Islander � White � Other (please specify)
She is Hispanic or latina: � Yes � No � I choose not to share at this time
Household income: � $0–$14,999 � $15,000–$34,999 � $35,000–$49,999 � $50,000–$74,999 � $75,000–$99,999 � $100,000 or more � I choose not to share at this time
yeS! I would like to make a donation today that directly benefits girls in our area. Enclosed is my tax-deductible donation in the amount of: (check one) � $500 � $250 � $100 � $50 � Other $
� Address is same as girl
parent/GuarDian inForMation
Parent/Guardian (1) First Name
Middle
Employer
(
)
(
)
Membership Fee: $ Donation: $ Total Attached: $ � Cash � Check* � Amex � Discover � Visa � MasterCard � Financial Assistance Request
Occupation
(
Home Phone
)
Business Phone
Cell Phone
� $150 � $25
annual MeMBerSHip: $15 payMent inForMation:
Last
Address
E-mail Address
i wish to opt in: � Texts � E-mails
Middle
Last
� Address is same as girl
(attach form) Parent/Guardian (2) First Name
� Cookie Credit � Other
Address Employer
Occupation
(
)
(
(
)
Home Phone
Credit Card # or Cookie Credit Card # i wish to opt in: � Texts � E-mails
E-mail Address
Media permission When participating in Girl Scout activities I may be photographed for print, videotaped, or electronically imaged. Images may be used in promotional materials, news releases, and other published formats for either the local Girl Scout Councils or Girl Scouts of the USA. The images will be the sole property of either the local Girl Scout Council or Girl Scouts of the USA. � I wish to opt out at this time.
Council Code: patHway oF entry:
Name on Credit Card
)
Business Phone
Cell Phone
perMiSSion
Girl Scouting builds girls of courage, confidence, and character, who make the world a better place.
Fun wayS to participate:
GSUSA ID (if known)
� I choose not to share at this time
aDMin uSe
Girl Scout MiSSion
the Girl Scout law I will do my best to be honest and fair, friendly and helpful, considerate and caring, courageous and strong, and responsible for what I say and do, and to respect myself and others, respect authority, use resources wisely, make the world a better place, and be a sister to every Girl Scout.
the Girl Scout promise On my honor, I will try: To serve God and my country, To help people at all times, And to live by the Girl Scout Law.
I/We acknowledge that the registrant will accept and abide by the Girl Scout Promise and Law. The registrant has permission to join Girl Scouts.
Signature of Parent/Guardian
Date
Signature of Parent/Guardian
Date
Service Unit/Team: � Camp
� Event
� Series
Expiration Date
When making the GS Promise, individual members may substitute wording appropriate to their own spiritual beliefs for the word “God.”
Group/Troop: � Travel
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� Troop
Signature Date *Make checks payable to Girl Scouts
tHank you For SupportinG Girl ScoutS! Learn more about Girl Scouts at www.girlscouts.org.
return this registration form, along with GSuSa membership fees to your local council. Fees are non-refundable or transferable to another person.
Girl Scouts of the Missouri Heartland, Inc.
Event Registration Form *Please complete all fields in their entirety; incomplete forms cannot be processed. Event Information Event Name ___________________________________________ Option (if applicable) ___________ Date _____________ Time ____________ Location ________________________________________ Registration Information 5-Digit Troop/Group # ___________ Service Unit Number _________ County ____________________ Age Level □ Daisy (K-1st)
□ Brownie (2nd-3rd)
□ Junior (4th-5th)
□ Cadette (6th-8th)
□ Senior (9th-10th)
□ Ambassador (11th-12th)
Attending Adult Name (if required) ______________________________________________________ If adult attendance is required to meet girl-adult safety ratios, then the adult(s) with the group will be responsible for bringing a signed parent permission and health history form for each girl attending, as per Girl Scout safety standards, and for keeping the forms with them during the program.
Address ___________________________________ City ______________State _____ Zip ________ Phone _____________________ Email __________________________________________________ (Confirmations sent via email unless otherwise requested. Do not attend the program if you have not received a confirmation.)
Parent/Guardian Name (if different than above) ____________________________________________ If girl is attending event individually, parent/guardian should send signed parent permission form and health history form to the event. Forms are available at www.girlscoutsmoheartland.org.
Email Address ______________________________________________________________________ (Confirmations sent via email unless otherwise requested. Do not attend the program if you have not received a confirmation. )
Program Fees (Check program description for pricing.) # of girls attending:
_____
x cost per girl:
$ ______ =
Total girl fees:
$________
# of adults attending:
_____
x cost per adult:
$ ______ =
Total adult fees:
$________
Total fees:
$________
# of girl/adult Girl Scout membership registrations: ______ x $15 =
TOTAL GIRL AND ADULT FEES Payment Methods Cash Check(s), made payable to Girl Scouts of the Missouri Heartland, Inc. Cookie Credit (if applicable) (Make sure to include 2-digit security code located on back of card). Cookie Credit Gift Card # _____________________________ - ____________ - __ __
Troop Bucks (if applicable)
(Make sure to include 2-digit security code located on back of card).
Troop Bucks Gift Card # _____________________________ - ____________ - __ __
Financial Assistance Application for Program Activities
(Financial assistance form must be attached for each person requesting it.)
Credit Card (Please complete information below.)
Credit Card Type: ___________ TOTAL ENCLOSED Card #: ______________________________ Expiration Date:________ Name on Card: _______________________ Signature: ________________________________
$________ $________ $________ $________ $________ $________ $________ $________
Trainings (Please check any that apply.) □ CPR/First Aid Certified Name: __________________________ Phone: (____)___________ □ BOS Trained
Name: __________________________ Phone: (____)___________
□ I am available to assist at the program as: □ First Aider
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□ Check-in Desk
Participants/Attendees
NOTE: Events are designed for specific numbers and ages of participants. First & Last Names of Children (under age 18)
Gender (M/F)
Grade
Age
City
Registered Girl Scout?
□ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No □ Yes □ No
Names of Adults
TOTAL
Payment Method(s) Fin. Asst.*
$
Cookie + Credit
$
Cash/ Check
$
*Financial Assistance is only available to registered Girl Scout members. + Girl Scout Cookie Credit may only be used to pay for the Girl Scout who earned it.
Please share if any person(s) in troop/group has special needs (e.g., allergies): ___________________
____________________________________________________________________________________ ____________________________________________________________________________________ This form, and any applicable event fees, must be received by the registration deadline. To ensure that your registration is only processed and charged once, please use only one of the following submission methods:
Fax to 417-862-4120 (must include credit card number for payment) Email to programs@girlscoutsmoheartland.org (must include credit card number for payment) Mail to a GSMH service center Walk in to a GSMH service center
For updated service center mailing addresses and hours, please visit www.girlscoutsmoheartland.org.
Girl Scouts of the Missouri Heartland, Inc.
T 877-312-4764 ● F 417-862-4120 ● www.girlscoutsmoheartland.org ● programs@girlscoutsmoheartland.org (Page 2 of 2) 14
P:\GSMOHEARTLAND DATA\Forms\Event Registration 6-10-13
Girl Scouts of the Missouri Heartland, Inc.
Retail Shop Mail-Order Form Ordering Information 1. GSMH Retail Shop orders may be placed by telephone (877-312-4764), fax (417-862-4120), e-mail (gscouts@girlscoutsmoheartland.org), or mail to: Girl Scouts of the Missouri Heartland, Attn: Retail Shops 210 S. Ingram Mill Rd, Springfield, MO 65802 â—? 1202 S. Range Line Rd, Ste 8, Joplin, MO 64801 230 Metro Drive, Jefferson City, MO 65109 â—? 1420 Girl Scout Way, Dexter, MO 63841 1432 Kurre Lane, Cape Girardeau, MO 63701 2. Payment may be made by check, credit card, or Girl Scout Cookie Credit. COD orders are not permitted. Please note that Girl Scout Cookie Credit may only be spent for the girl who has earned it. 3. Fulfillment of order is subject to availability. 4. Please allow 7 to 10 days from receipt of order for delivery. 5. Refunds and exchanges will be given on purchases when merchandise is returned within 30 days with receipt. All merchandise must be current (no discontinued items) and in original condition, have all tags attached and be accompanied by a receipt. Refunds over $25 will be given in the form of a check issued within two weeks of the return.
Order Detail Name ______________________________________ Service Unit _________ Troop # ____________ Mailing Address ____________________________________ City/State/ZIP _____________________ Phone Number ___________________ E-mail ____________________________________________ Qty
Item Number
Description
(listed before price)
Size
Shipping and Handling Charges Orders under $5.00 Orders $5.01 to $25.00 Orders $25.01 to $50.00 Orders $50.01 to $75.00
$ $ $ $
2.00 Orders $ 75.01 to $100.00 $11.95 5.95 Orders $100.01 to $200.00 $14.95 7.95 Orders $200.01 and over $20.95 9.95
Color
Unit Price
TOTAL ORDERED $ SHIPPING & HANDLING $ TOTAL AMT DUE $
Payment Methods Check(s), made payable to Girl Scouts of the Missouri Heartland, Inc. Cookie Credit (if applicable) (Make sure to include 2-digit security code located on back of card). Cookie Credit Gift Card #: __ __ __ __ __ __ __ __ __ __ __ __ - __ __ __ __ __ - __ __
Credit Card (Please complete information below.)
Credit Card Type: ___________ TOTAL ENCLOSED Card #: ______________________________ Expiration Date:________ Name on Card: _______________________ Signature: ________________________________
For questions about your order, please call the GSMH Retail Shops at 877-312-4764. P:/GSMOHEARTLAND DATA\Forms\Shop\Shop Mail Order 5-7-2013
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Total Price
$________ $________ $________ $________
Girl Scouts of the Missouri Heartland, Inc. 210 S. Ingram Mill Rd. Springfield, MO 65802-6100
Non-Profit Org. U.S. Postage PAID Columbia, MO Permit No. 353
a newsletter for girl scout daisies and brownies
The cute little owl you may have seen hanging around our website is named ROSE and stands for Registrations Online—Simple and Easy. With ROSE, you can do just that—register for Girl Scout membership online the simple and easy way—with no paperwork!
ROSE
How do you get to Online Registration?
Just remember ROSE—Registrations Online Simple and Easy. Anywhere you see ROSE on the Girl Scouts of the Missouri Heartland website, you can click her and be taken to the Online Registration system. You may also navigate your browser to: www.girlscoutsmoheartland.org/rose.
GSMH
Adults and girls who register for membership using ROSE by March 31, 2014 will receive this ROSE patch! Patches will be delivered to troop leaders at service unit meetings or you can pick one up at any GSMH service center. 16
RO
online registration
SE
GSMH 2013-14