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Program Planning Worksheet

Program Planning Worksheet

Please complete this application for approval at least three (3) months prior to the proposed activity. Note that the contact person listed on this form will be the contact person listed in the online program posting.
Contact Name
First
Last
Address
Street Address
Apt./Ste.
City
State
Postal Code
Phone Number
Area Code
Phone Number
E-mail
Preferred Method of Contact
Service Unit
Troop Number
Name of Program
Program Level
Pathway Delivery
Grade(s)
Please list the min and max numbers
Projected Number of Girls
Projected Number of Adults
Will the Program include non-Girl Scouts?
(4hr, 8hr, one day a week, etc)
Duration
Date(s) of Program
Location of Program
Address of Program
Street Address
Apt./Ste.
City
State
Postal Code
Deadline to Register
Time of Program
Cost of Program
Descripition of Program
How will you incorporate Girl Planning
Will this program be a money-earning project?

Potential Collaborators/ Partners

Name
First
Last
Organization
Position
E-mail
Phone
Area Code
Phone Number
Name
First
Last
Organization
Position
E-mail
Phone
Area Code
Phone Number

Which outcomes does this program meet?

Check all that apply.
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