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.
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.
Did you participate in the Fall Product Sale in 2023?*

YesNo
Are you participating in the Cookie Sale in 2024?*

YesNo
Have you ever been on a Destination or Council Trip?*

YesNo
If Yes, which one?*
Did you previously receive a scholarship?*

YesNo
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?

YesNo
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: