Program Credit Transfer Request

Program Credit Transfer Request

form #238 | 08/25
Submitting a Program Credit Transfer Request facilitates the transfer of Program Credits to group accounts for Girl Scouts to participate in programmatic activities. Program Credits are individual recognitions earned by Girl Scouts for participation in GSOSW sponsored Product Programs. Program Credits include Cookie Program Credits, Adventure Pass, Fall/Nut Credits, and Pathway Cards.
Program Credit Transfer Request Guidelines:
By submitting this form, you accept understanding on compliance of all terms listed above.

Program Credit Transfer Request

When filling out this form, you have to option to save your work and return to it later if needed. Be sure to select submit once the form is filled out.
Submitted By
Your Troop Number
Leave blank if not applicable
Service Unit
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Include any other emails to receive confirmation and updates for this request
Separate multiple emails with a comma - example@email.com, ex2@email.com
Credits used for:

Other

Program Credit Transfer Request — Day Camp
Day Camp Reminders:
- Program Credit may not be used towards adult or non-Girl Scout sibling fees.
- Credit sharing between registered girl members is permitted.
  - If you are unable to get the written permission for Girl Scouts sharing credits, still submit the request. Council will do its best to get the permission and will notify you of any updates.
- If your camp offers additional options like sweatshirts, Girl Scouts can use their program credits towards those costs as well. Adjust the "amount to charge" section on the next page to reflect any additional purchases.
Camp Name
Cost of Camp per Youth
Last four (4) digits of bank account for deposit (ACH)

Program Credit Transfer Request — Transfer Details
We assume the transfer is being paid to the Service Unit/Troop/Patrol associated with your name on this form. The submitting party should be the party to receive the transfer.

We discourage one Girl Scout group from requesting payment be made to another. For example, we discourage a troop from submitting a payment request to be made to a day camp. Instead, the day camp should be the one to request the transfer to be made into their own account.

Exception: Payment is being made for a GSUSA Destination. You will identify who the payee is for a Destination trip later in this form.
Last four (4) digits of bank account for deposit (ACH)

Program Credit Transfer Request — Events and Activities
Event/Activity Name
Cost of Event per Youth

Program Credit Transfer Request — Travel
Travel Information
How will GSOSW pay for your GSUSA Destination?

Other
Based on your payment type, please write in your payment information or upload the following documentation, including the next payment due date:
- Reimbursement for out-of-pocket payment - Copy of receipt of payment. You'll need to identify in the next question if you want the reimbursement mailed as a check, or as an ACH deposit (which requires completing an Automated Deposit Authorization form#152). Please confirm that you've completed the form in your notes below.
- Payment to the hosting Girl Scout Council - Information provided by the hosting Girl Scout Council on how payment should be made. This could include a remittance address or details on how we can make payment online or over the phone.
- Payment to a non-Girl Scout-run tour company (Ex: Explorica/EF Tours) - Account ID and any identifying information we can use to make payment over the phone. Or, if your host offers it a donation link that we can contribute to by card, online.
- Other - Information on how payment should be made including contact of recieving party, reference/account number for the Girl Scouts account.
  - If your troop will be making the payment from their account, please include your Troop Number and the Troops last 4 digits of their bank account (ACH)
Write in Payment Information:
Please provide the details outlined in the description above, including when your next payment is due.
Travel Approval & Documentation Upload- This includes approval verification for Extended travel, Destiantion details, and receipt for reimbursement requests.

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Program Credit Transfer Request

When filling out this form, you have to option to save your work and return to it later if needed. Be sure to select submit once the form is filled out.
Card Information: Please include the 17 to 19-digit number with no spaces. Do not include the pin number. You can add multiple entries for the same youth who has multiple cards, or additional youth. We encourage consolidating multiple entries into one request for the same event/activity whenever possible to improve processing times.
Total Amount Requested:
Add the amounts for all listed cards above
I have received handwritten notice from the youth card owner specifiying their intent to share credits, with whom, for what purpose and in what amount, and will submit documentation below:

Cancelof
Should be Empty:

Program Credit Transfer Request

Program Credit Transfer Request

Program Credit Transfer Request — Day Camp

Program Credit Transfer Request — Transfer Details

Program Credit Transfer Request — Events and Activities

Program Credit Transfer Request — Travel

Program Credit Transfer Request