GSCCVA Gold Award

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Applications are accepted year-round.
Gold Awards are reviewed after October 1 & March 1 of each year.

Personal Information

Today's Date:

Name:

Address:

City:

State:

Zip:

Date of Birth:

Phone:

Your E-Mail:

Age:

Grade:

School:

Year Graduate High School:

Troop/Group Number:

or Juliette

# of Years in Girl Scouts:

Troop/Group Advisor:

Troop/Group Advisor's Phone:

Troop/Group Advisor's Email:

Mother/Guardian:

Father/Guardian:

Family Email:

Girl Scout Gold Award Project Title:

Get Ready

Gold Scout Award Project Advisor:

Project Advisor's Phone:

Project Advisor's Email:

Timeline developed by you and your advisor:

Girl Scout Gold Leadership Award

Activities	Date Completed
1. Earn It
Interest Project:
Interest Project:
Interest Project:
2. STUDIO 2B Focus Book:
3. Lead It (30 hours) Describe:

Girl Scout Gold Career Award

Describe 40 hour career related activity	Date Completed

Girl Scout Gold 4 B's Challenge Award

Activities	Date Completed
A. Become
B. Belong
C. Believe
D. Build

Girl Scout Gold Award Project

Title of Project:

Proposed Start Date:

Proposed Completion Date:

Describe the issue your project will address, what you hope to achieve, and who will benefit.

Discuss the reasons for selecting this project.

Outline your strengths, talents, and skills that will be put into action.

Describe the steps involved for putting your plan into action, including facilities and/or
equipment needed.

Indicate methods and/or tools you will utilize to evaluate the effectiveness of your project.

List the names of advisors and resources you plan to use.

Estimate overall project expenses and how you plan to meet these costs.

Please retype your name for your signature: Date:

Girl Scout Gold Award Project Advisor's signature: Date:

Please retype Parent/Guardian name for signature: Date:

Email Confirmation: A copy of this report will be emailed to your project advisor for approval and to you to retain for your records. A signature is not required for electronic forms. Please enter your email address and the email address of your project advisor:

Your Email Address:

Project Advisor's Email Address:

Family Email Address: