Girl Scout Silver Award Project Intent Form Page 1 of 6

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1 GIRL SCOUT SILVER AWARD INTENT FORM Please type in black ink. Please make a copy of the completed form for your records. Once you have received the official letter of approval from Council, you may begin your project. Remember to allow up to 3-4 weeks for your letter of approval to be received. All of the bolded text is required information and must be completed. Questions? Contact Customer Care at ext. 391 First Name Last Name Date Submitted Street Address City Zip Code Home Phone Cell Phone Address Troop Community Grade Troop Leader Contact Phone Contact Parent/Guardian Contact Phone Contact Project Advisor Contact Phone Contact Project Advisor Organization Organization s Primary Contact Information Projected Begin Date Targeted End Date Project Title Project Description (only 3-5 sentences): Girl Scout Silver Award Project Intent Form Page 1 of 6

2 Registered Girl Scout Cadette (grades 6-8) Completed 1 Girl Scout Cadette Journey Prerequisites Journey Date Completed Troop Leader Signature Troop Leader Phone Project Partner 1: Project Partner 2: Project Partner 3: Project Team Please note a Silver Award project team may not exceed four girls. Team Members NOT including your project partners, list the team and/or community members and what the role that they will play in your project. Other Team Member Organization Role Played Girl Scout Silver Award Project Intent Form Page 2 of 6

3 Project Overview Please answer all of the questions below to the best of your knowledge. Incomplete forms will not receive an official letter of approval. Girls should not begin their project until after they have received the official letter of approval. Please keep track of all hours for the Final Report. I want to raise money for my project and/or ask for in-kind donations. Complete the Money-Earning/Solicitation Form and submit to Customer Care at ext You may not raise money or ask for any form of donations until approval is received from Council. If yes, please explain fully below. Yes No I need to use a Council camp or Girl Scout property. Remember to make reservations with the Property Department. Yes No If yes, please explain fully below. My project will involve Girl Scouts. Remember that your project must benefit the community, not just Scouts. Yes No If yes, please explain fully below. Girl Scout Silver Award Project Intent Form Page 3 of 6

4 By signing below, the girl and parent/guardian admit that all information in the Girl Scout Silver Award Project Intent Form is true and correct and will abide requirements as stipulated by Girl Scouts of USA and Girl Scouts of Southwest Texas, including the minimum of 50 hours service for the project. By signing below, the girl and the parent/guardian amend that the official letter of approval may take a minimum of three to four weeks for processing and that the girl will receive the official letter of approval as soon as it becomes available. PUBLICITY RELEASE: For good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, I hereby consent and agree to the following: 1. I hereby grant to Girl Scouts of the USA (GSUSA), and others working for GSUSA or on its behalf, and each of its respective licensees, successors, and assigns (each a Releasee ), the irrevocable, royalty-free, perpetual, unlimited right and permission to use, distribute, publish, exhibit, digitize, broadcast, display, modify, create derivative works of, reproduce or otherwise exploit my name, picture, likeness, and voice (including any video footage of the same) (collectively Media), or to refrain from so doing, anywhere in the world, by any persons or entities deemed appropriate by GSUSA, for any purpose (except defamatory) including, without limitation, any use for educational, advertising, non-commercial or commercial purposes in any manner or media whatsoever (whether known or hereafter devised) including, without limitation, on the internet, in print campaigns, in-store and via television. I agree that I have no interest or ownership in any of the Media. 2. I shall have no right of approval, no claim to compensation and no claim (including, without limitation, claims based upon invasion of privacy, defamation or right of publicity) arising out of any use, alteration, blurring, illusionary effect or use in any composite form of my name, picture, likeness, and voice. I agree that nothing in this Release will create any obligation on GSUSA to make any use of the Media or the rights granted in this Release. I hereby release and hold harmless Releasees from any claim for injury, compensation, or negligence resulting or arising from any activities authorized by this Release and any use of the Media by GSUSA. Girl Signature Date Parent/Guardian Signature Date Girl Scout Silver Award Project Intent Form Page 4 of 6

5 SILVER AWARD PROJECT HOURS LOG (FOR YOUR RECORDS) Please keep track of all of the hours spent on your project. Include planning, research, shopping, preparation, organization, transportation, communication, and all other aspects of implementing your project. Hours do NOT include time spent completing the prerequisite journey. Please submit this form with your Silver Award Final Report and keep a copy for your records. REMEMBER THAT THE SILVER AWARD REQUIRES A MINIMUM OF 50 HOURS OF SERVICE. First Name Last Name Date Submitted Street Address City Zip Code Home Phone Cell Phone Address Troop Community Grade Parent/Guardian Contact Phone Contact Date Description of Project Activity Time Spent Adult Signature Total Hours Girl Scout Silver Award Project Intent Form Page 5 of 6

6 SILVER AWARD CHECKLIST (FOR YOUR RECORDS) Completed one Cadette Journey: Journey Date Identified an issue I cared about: Picked a Project: I am doing my project by myself or with a team Found to be my Advisor Identified Team Members in my community to help Developed a plan Know where my funds/donations are coming from Submitted my Silver Award Intent Form Received my official letter of approval for my Silver Award project Finished my project: Submitted all materials to Council before publishing Completed the Hours Log Completed the Income and Expenses Log Informed Council of any major changes to my project Submitted my Silver Award Final Report: Attached the official letter of approval Attached the Hours Log Attached the Income and Expenses Log Filled out all questions completely Received my official letter of approval for my Silver Award Final Report Celebrated my achievement: Purchased my Silver Award Pin Purchased my Silver Award Patch Received my Certificate Girls must submit their Girl Scout Silver Award Final Report no later than SEPTEMBER 30 of the year they enter high school or 9 th grade. If a girl wishes to participate in Celebrations, the deadline for submission of the final report with all of the attachments is March 15. For more information, please contact Customer Care at ext Girl Scout Silver Award Project Intent Form Page 6 of 6