Adult Recognition- Years of Service and Membership Numerals

Adult Recognition- Years of Service and Membership Numerals
Use this form to request Girl Scout Years of Service or Membership Numerals recognition. Each are awarded in 5-year increments. This includes the two options below:

1) Years of Service Pin: This pin recognizes volunteers for their total number of active volunteer service to Girl Scouts (this does not include years as a girl member.)

2) Membership Numerals (Casually Referred to as Tenure Pin): This pin recognizes the total number of years - both as a girl and adult - registered with Girl Scouts of the USA.
Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Community
Which award(s) are you applying for?
If requesting the Years of Service Pin (Volunteer Years ONLY), please select the year below:
If you selected "Other" above, please specify the 5-year increment for which you are seeking recognition
If requesting the Membership Numerals (Girl and Adult Years COMBINED), please select the year below:
If you selected "Other" above, please specify the 5-year increment for which you are seeking recognition
Should be Empty: