Rocket Recruiter Patch Request
Adult caregivers and volunteers: Complete this form after your Girl Scout(s) have completed a qualifying recruitment activity. Fill out this form for each separate activity and include the names of all of the girls who participated in the activity.
Email
*
example@example.com
Submitter's Name
*
First and last
Troop Number or Juliette's Name
*
i.e. "12345", or "Juliette - Jennifer Smith"
Service Unit
*
Please Select
Unknown
Service Unit 1
Service Unit 2
Service Unit 5
Service Unit 6
Service Unit 7
Service Unit 8
Service Unit 9
Service Unit 10
Service Unit 11
Service Unit 12
Service Unit 13
Service Unit 14
Service Unit 15
Service Unit 16
Service Unit 17
Service Unit 18
Service Unit 19
Service Unit 20
Service Unit 22
Service Unit 23
Service Unit 25
Service Unit 26
Service Unit 27
Service Unit 28
Service Unit 29
Service Unit 30
Service Unit 61
Service Unit 62
Service Unit 63
Service Unit 64
Service Unit 65
Service Unit 66
Service Unit 67
Service Unit 68
Service Unit 69
Service Unit 70
Service Unit 71
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Girl Information
Each Girl Scout earns a Rocket Recruiter fun patch for their first activity each year, followed by stars for each additional activity.
Girl Scout Name(s)
*
Enter all girl's names with a comma in between
How many Rocket Patches are you requesting?
*
One per scout for first activity
How many Star Patches are you requesting?
*
One per scout per activity after receiving the Rocket Patch
What did the girl(s) do to share Girl Scouts in her community?
*
Hosted/volunteered at a service unit-run recruitment event
Volunteered at a staff-run recruitment event
Displayed a recruitment table tent at a cookie booth during the Cookie Program
Posted Girl Scout fliers at grocery stores, libraries, schools, businesses, or local bulletin boards
Put up a Girl Scout yard sign in your neighborhood
Wore her Girl Scout uniform to school and talked to at least one person about Girl Scouts
Brought a friend to a Girl Scout event so they can try out Girl Scouts
Other
When did this event take place?
*
/
Month
/
Day
Year
Date
Submit
Should be Empty: