GSEMA Program Financial Assistance

GSEMA Program Financial Assistance
Please read the following information before submitting your financial assistance request.

IMPORTANT CAMP FINANCIAL ASSISTANCE INFORMATION BELOW

If this is a request for summer camp financial assistance, please do not fill out this form. Instead go to CampInTouch and complete your online camp application (including your deposit). Once you have submitted your application, go into the CampInTouch Forms & Document's section and fill out the camp financial assistance form.

This form is only to request financial assistance to Girl Scouts of Eastern Massachusetts youth members wanting to attend a GSEMA program (not membership assistance). At this time, we are not able to provide financial assistance to Program Partners or adults wanting to attend a program.

Please complete this online form (one month prior to the program date) to request youth financial assistance and register for an upcoming Girl Scouts of Eastern Massachusetts program. Within 2 weeks of your submission, you will be notified via email of our decision and if approved, we must receive your remaining balance payment within 3 business days to be registered for the program.

In order to assist as many Girl Scouts as possible while aid is available, the number of program requests that can be submitted is limited. Families may submit either 5 requests for aid or up to $150 worth of requests (whichever comes first) for each Girl Scout during the council year. This limitation is separate from requests for April Vacation Adventures or Camp financial aid.

Important Note - Refunds will not be issued for programs that have been paid for in full and then a financial assistance form has been submitted after the fact.

If you have any questions regarding program financial assistance, e-mail customercare@gsema.org.

Program Registration Form

Please fill out this form regarding the program you would like to attend.
Girl's Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Day Phone*

Area CodePhone Number
Email*
example@example.com
Troop Number
Daisy (Grades K-1)Brownie (Grades 2-3)Junior (Grades 4-5)Cadette (Grades 6-8)Senior (Grades 9-10)Ambassador (Grades 11-12)
Program Name*
This is not the Financial Aid form for camp. Instead go to CampInTouch and complete your online camp application (including your deposit). Once you have submitted your application, go into the CampInTouch Forms & Document's section and fill out the camp financial assistance form.
Date and Time of Program*

MonthDayYear
DateHourMinutesAM/PM Option
Chaperone Name*

First NameLast Name

Program Financial Assistance Section

Please fill out this section regarding assistance needed.
Program Cost*
Girl and Family Contribution towards Program Cost (You must contribute towards program)*
Amount of Financial Assistance Requested*
Annual Household Income*

Number of People in Household*

Rows	Amount (#)
Adults
Children

Please describe any unusual circumstances that you would like considered.
Parent/Guardian Name Submitting Request*
Yes
Should be Empty:

GSEMA Program Financial Assistance

Program Registration Form

Program Financial Assistance Section