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Financial Assistance for Membership Dues Form

This form is to be completed in combination with registration in order to be considered elgible for financial assistance towards membership dues. A paper copy of this form can be found here, and can be submitted to any Girl Scouts of Northern Illinois Resource Center. If you have questions about financial assistance, please contact Customer Care at customercare@girlscoutsni.org or at 844-GSNI-4-ME (844-476-4463).

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Please include the name(s) of all members requesting financial assistance.
 
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 I marked financial assistance by mistake.
If selecting this option, there is no need to continue to fill out the rest of the form. You can also call in your membership dues payment ($25 per registrant) to 844-476-4463.
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 Girl Scout Fall Product Program
 Girl Scout Cookie Program
 Service project through Girl Scouts
 I understand that not all requests may be granted. I verify that I am unable to fund membership dues without financial assistance.