Girl Scouts of River Bluffs Council • #4 Ginger Creek Parkway • Glen Carbon, IL 62034

(618) 692-0692 - (800) 345-6858 - FAX (618) 692-0685  • gsrbc@riverbluffs.org

Girl Scout Bronze Award Intent Form

This form must be submitted at least a month prior to beginning your project.

Name (Last)______________________________ First____________________________ Middle_______________

Address______________________________________City____________________________ST_____Zip________

Phone (D)__________________________________________(E)_________________________________________

Age_____________________________________________Grade________________________________________

E-mail___________________________________________________Troop #_________ Service Unit___________

Leader's Name____________________________________Phone (D)____________________________________

E-Mail_______________________________________________________________________________________

Project Title__________________________________________________________________________________

Project Description____________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

How will this project help your community?_________________________________________________________

____________________________________________________________________________________________

Will you be working on this project by yourself? (circle one)  YES    NO

If doing the project in a group, how many girls will be working on this project including you? ________________

I plan to complete my Girl Scout Bronze Award Project by (date)_______________________________________

As soon as this is complete give to your leader to sign and date

Leader's Signature__________________________________________________Date____________________

Leader, please mail to

Carolyn Miener, Program Manager, #4 Ginger Creek Parkway, Glen Carbon, IL 62034