Destination Scholarship Application

Destination Scholarship Application
First-round applications are due by 11:59 PM December 15.

Applications received after December 15 will be considered on a rolling basis while scholarship funds remain.

Destination participants may submit an updated application if their circumstances change.
Date

MonthDayYear
Date
Destination Participant's Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Age
Grade
Troop Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Destination Participant Email
example@example.com
Community
Parent/Guardian Name

Parent First NameParent Last Name
Parent/Guardian Email
example@example.com
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Did you participate in the Fall Product Sale in 2023?
Are you participating in the Cookie Sale in 2024?
Have you ever been on a Destination or Council Trip?
If Yes, which one?
Did you previously receive a scholarship?
Destination Name
Destination Location
Destination Host Council
Destination Dates
Why are you requesting this scholarship?
What is the Household income?
How many adults live in your household?
How many children/youth live in your household?
Are any other youth in your household going on a destination or similar experience this summer?
If yes, please explain:
Estimated Expenses

(We do not provide assistance for GS uniforms, personal clothing, medications, or cameras. Please research flights to provide as accurate an estimation as possible.)
Event Fee
Transportation (include airline):
Physical Exam / Vaccinations:
Special Equipment or Other Items Required for participation in this event (please specify):
Total Cost
Trip Financing
Amount of money contributed by you:
Amount of money contributed by your family and/or friends
Amount of money contributed by your troop:
Amount of money contributed by your Community:
Amount of money you are requesting from GSSJC:
Date

MonthDayYear
Date
Destination Participant Signature

Clear
Date

MonthDayYear
Date
Parent Signature

Clear
Should be Empty: