2024-2025 Parent Debt Form
Troops must complete this form to report a parent who owes money to their troop from either the Fall Product or Cookie Program. The reported amount will be deducted from the total amount due from the troop. *Please note – if the parent/family reaches out to you to pay their Parent Debt after you filled out this form, please do not accept payment and instead refer them to contact troopbanking@gshpa.org. Please use one (1) form per girl.
Name of Girl Scout
*
First Name
Last Name
Name of Parent/Guardian who signed the Parent/Guardian Permission Form.
*
First Name
Last Name
Additional Parent/Guardian Name (if applicable)
First Name
Last Name
5-Digit Troop Number
*
Service Unit Number
Address of Girl Scout
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number of Parent/Guardian
*
-
Area Code
Phone Number
Additional Phone Number of Parent/Guardian
-
Area Code
Phone Number
Email Address of Parent/Guardian
*
example@example.com
Name of Person Completing Form
*
First Name
Last Name
Email of Person Completing Form
*
example@example.com
Phone Number of Person Completing Form
*
-
Area Code
Phone Number
Please explain attempts made to receive funds from Parent/Guardian. (In person, phone, email, etc)
Total amount parent/guardian owes troop
*
Please upload documentation verifying collection attempts. If you cannot upload, please email directly to troopbanking@gshpa.org and include your Troop # and Troop Banking Parent Debt Form in the subject line.
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Please upload the signed Family Agreement Form signed by parent/caregiver showing the agree to payment in full. If you cannot attach, please email directly to troopbanking@gshpa.org and include your Troop # and Troop Baking Parent Debt Form in the subject line.
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*
Use your camera to take a photo of the signed Family Agreement Form.
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