GO! Dough Usage Form
Please let us know how you would like to use your GO! Dough. Note: We will process your request in the order in which it was received. If you have any questions, please contact Member Services at 717-233-1656 or email us at memberservices@gshpa.org.
Person Requesting Use of GO!Dough:
*
Parent/Guardian of Girl Scout
Troop Leader or Service Unit Volunteer
Name of Parent/Guardian Requesting GO! Dough
*
First Name
Last Name
Requester Phone Number
*
-
Country Code
-
Area Code
Phone Number
Requester Email
*
example@example.com
I would like to use my GO! Dough for:
*
Membership Renewal (Household Members Only)
Lifetime Membership (18 years old/HS Graduate)
GSHPA Camp/Event/Program (see GSHPA website calendar)
Purchase GSUSA Online Gift Card ($10, $25, $50 or $100)
Purchase GSHPA (Council) Shopify Gift Card ($10, $25, $50 or $100)
Transfer to Troop or Service Unit
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Amount of GO! Dough to be used:
*
Number of Memberships being Renewed with GO! Dough Today:
*
1
2
3
4
5
Girl Scout or Household Member (1)
*
First Name
Last Name
Girl Scout or Household Member (2)
First Name
Last Name
Girl Scout or Household Member (3)
First Name
Last Name
Girl Scout or Household Member (4)
First Name
Last Name
Girl Scout or Household Member (5)
First Name
Last Name
Amount of GO! Dough to be used:
*
If the amount does not cover the full cost, you will receive a call or email from GSHPA Member Services.
Girl Scout Receiving Lifetime Membership
*
First Name
Last Name
Email for New Lifetime Member:
example@example.com
Amount of GO! Dough to be used:
*
Name of GSHPA Program:
*
Date of GSHPA Program
*
-
Month
-
Day
Year
Date
Girl Scout Name
*
First Name
Last Name
Amount of GO! Dough to be used:
*
The amount of the GO! Dough being used must equal the cost of the gift card(s).
Quantity of each Online Gift Card (Please note: GSHPA Gift Card turnaround time is 5-7 business days)
*
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( X )
$10 Online Gift Card
Enter description
$
10.00
Quantity
1
2
3
4
5
6
7
8
9
10
$25 Online Gift Card
$
25.00
Quantity
1
2
3
4
5
6
7
8
9
10
$50 Online Gift Card
$
50.00
Quantity
1
2
3
4
5
6
7
8
9
10
$100 Online Gift Card
$
100.00
Quantity
1
2
3
4
5
6
7
8
9
10
Girl Scout Name
*
First Name
Last Name
Email Address of Online Gift Card recipient:
*
example@example.com
Amount of GO! Dough to be used:
*
Receiving Troop or Service Unit Number:
*
Name of Girl Scout who is Transferring her GO! Dough:
*
First Name
Last Name
Is this for a Troop or Service Unit?
*
Please enter Troop or Service Unit Number.
*
Please enter bank name and last 4 digits of account number.
*
What will the GO! Dough be used for:
Activity or Event
Supplies
Other
Name of Activity or Event
Location of Activity or Event
Date of Activity or Event
-
Month
-
Day
Year
Date
Other, please explain.
Please verify that you are human
*
Submit
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