Day Camp and Overnight Camp Financial Assistance Application

Day Camp and Overnight Camp Financial Assistance Application
Girl Scouts of Southern Illinois is committed to offering summer camp opportunities to all girls, regardless of their ability to pay the full fee. Please consider the following requirements before completing this form:
- Girl for whom financial assistance is being requested must be a member of the Girl Scouts of Southern Illinois council
- Financial assistance application must be completed in its entirety prior to registering for a camp session
- Individual girls will only receive assistance for one day camp AND one overnight camp each year
- Overnight camp applicants should register for camp and pay the $100 deposit to reserve their space
- It is the responsibility of the Caregiver to ensure the girl’s balance is paid in full by the registration deadline or the girl’s spot will be forfeited
- Day Camp Financial Assistance, if approved, is for 50% of the Day Camp fee
For Day Camps: Once this application is processed, Customer Care will email the Caregiver, stating the amount approved. It is the responsibility of the Caregiver to ensure the girl is registered and paid for the Day Camp requested.

For questions about this form or the process, please contact Customer Care at customercare@gsofsi.org or (800) 345-6858
Girl's Name*

First NameLast Name
Girl's Date of Birth*

MonthDayYear
Date
Troop Number (enter "Juliette" if registered independently)*
Number of Years in Girl Scouts*
Grade Level in Fall of 2025*

GS Daisy (Kindergarten-1st grade)GS Brownie (2nd-3rd grade)GS Junior (4th-5th grade)GS Cadette (6th-8th grade)GS Senior (9th-10th grade)GS Ambassador (11th-12th grade)
Caregiver Name*

First NameLast Name
Caregiver Email*
example@example.com
Caregiver Phone*
Please enter a valid phone number.
Caregiver Zip Code*

Street Address

Street Address Line 2

City

Zip Code
Is the application for Day Camp or Overnight Camp?*

Day CampOvernight Camp
Day Camp Attending*

6/5/25-6/6/25 Mini STEM Day Camp: NextGen Coders - Edwardsville - D-B $706/6/25-6/8/25 Outdoor Journey Day Camp - SU521 Day Camp - D-A6/9/25-6/13/25 Marvelous Hero Academy - SU 109 Day Camp - D-A6/9/25-6/13/25 Myths and Legends - 207 Day Camp $556/10/25-6/12/25 SU201 Day Camp - Mission to Mars $456/23/25-6/25/25 Gallop and Glow Horseback Riding Day Camp - Week I at Greenville University - CSA $2506/23/25-6/27/25 Animal Adventures Day Camp - D-B $1506/23/25-6/27/25 SU108 Day Camp - Camp Surprise $806/23/25-6/27/25 SU211 "Whodunit" Day Camp $756/27/25-6/29/25 SU9 Science Safari - SU 9 Day Camp $356/27/25-6/29/25 Wilderness Wonders - SU 9 Day Camp D-A $206/30/25-7/2/25 Gallop and Glow Horseback Riding Day Camp - Week II at Greenville University - CSA $2506/30/25-7/3/25 SU57 Day Camp - Camp Splish Splash $507/7/25-7/9/25 SU54 Day Camp - Camp Ready, Set, Scout $757/14/25-7/18/25 STEM Camp Xlll: Mystery Bots7/29/25-7/30/25 Mini STEM Day Camp: NextGen Coders - Mt. Vernon - D-B $70
Overnight Camp Attending*

6/15/25-6/19/25 Overnight Camp - Camp Midnights $5006/15/25-6/20/25 Animal Adventures Returns! Overnight Camp $5007/6/25-7/8/25 Fairy Forest Explorer Mini Overnight Camp $2507/6/25-7/10/25 Adventure Trails Overnight Camp $5007/13/25-7/18/25 STEM Camp Xlll: Mystery Bots (Overnight option)
Has this girl received Day Camp or Overnight Camp financial assistance before?*

YesNo
When was the previous financial assistance received?*
Household gross income over the last year (include all sources of income, such as child support, unemployment, disability, social security, public assistance, etc.)*
Household Size (number of individuals)*
Is this girl also applying for Girl Scouts Experience Funds (GSEF) for this camp session?*

YesNo
If the registrant is also applying for Girl Scout Experience Fund, the application must be turned in before the registration deadline and before filling out this financial assistance request.
Please enter any further information to help us make a decision about this application
Caregiver Signature: By signing below, you acknowledge that the above information is accurate to the best of your knowledge.*

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