Bronze Charm

APPLICATION FOR THE SYBAQUAY BRONZE CHARM

NOMINEE INFORMATION

Name of Nominee:

Address:		City/Zip:
Telephone:		Girl Scout Service Unit:
E-mail Address:

Past and Current Position(s) in Girl Scouting:

Previous Recognition Received (award/year):

NOMINATING INDIVIDUAL(S) or GROUP

Name(s):

Contact Person:

Address:		City/Zip:
Day Telephone:		Evening Telephone:
E-mail Address:

NOMINEE'S LOCAL NEWSPAPER(S)

Describe the service given to Girl Scouting:

Describe the impact this service had on the work of the geographic area beyond the expectations of the position held.

Describe who benefited from this service

What was the impact of the volunteer's service on the geographic area, service unit, council and/or Girl Scouting.

Two additional letters of recommendation: The letters should reflect the criteria of the award and present examples, facts, dates, positions, etc. (refer to cover sheet):

	Name	Address	Telephone
1.
2.

Sybaquay Council

Bronze Charm