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2023 Bronze Award Girl Scout Report Form
Girl Scouts of Orange County is pleased to recognize Bronze Award Girl Scouts in the annual GSOC Highest Awards Yearbook! Upon completion of the project, submit one form per project for Girl Scout Juniors in grades 4-5 who have earned the Girl Scout Bronze Award during the 2022-2023 Girl Scout membership year (September 30, 2022 - October 1, 2023).
To submit a project for a different award year (ie. 2022, 2021 etc.), contact Customer Care at CustomerCare@girlscoutsoc.org to request a link for the correct Report Form.
Girl Scout Junior Information
Troop # (or Juliette):
*
Enter "Juliette" if you are not a member of a troop; enter unsure if you don't know/remember the troop number.
Troop Name (optional):
Service Unit (Region)
*
Please select
Aliso Viejo (505) South Coast
Anaheim (104) Northwest
Anaheim Hills (205) Central
Brea (101) Northwest
Fullerton/La Habra (102) North Central
Garden Valley (401) North Central
HB Pierside (305) Central Coast
Heart of Irvine (502) Mid South
Huntington Harbor (303) Central Coast
La Cypress Park (103) Northwest
Ladera Valley (607) South County
Laguna Beach (504) South Coast
Lake Forest (602) Mid South
Los Alamitos/Rossmoor (105) Northwest
Mission Viejo (604) South County
Newport Harbor (405) Central
Newport Mesa (404) Central
Niguel Coast (506) South Coast
North Irvine (503) Mid South
Ocean View (304) Central Coast
Orange Villa (204) Northeast
Oso Valley (606) South County
Placentia (201) Northeast
Rancho Portola (603) South County
Rancho Trabuco (605) South County
San Clemente (507) South Coast
Santiago Creek (206) Northeast
Seal Beach (301) North Central
South Irvine (501) Mid South
Surf City (306) Central Coast
Tustana (402) Central
Tustin East (403) Central
West Garden (302) North Central
Yorba Linda East (203) Northeast
Yorba Linda West (202) Northeast
I don't know
Contact Information
Your Name
*
First
Last
Email
*
Bronze Award Take Action Project Information
Project completed by:
*
Please select
1 Girl Scout (Individual)
2 Girl Scouts (Partner)
3-5 Girl Scouts (Team)
6-9 Girl Scouts (Group)
10 or more Girl Scouts (Troop)
Number of girls who completed this project:
*
Individual - First and Last Name of girl who completed the project:
*
First Name
Last Name
City
Grade (4 or 5)
School
# of years as a Girl Scout
Plans to earn the Silver Award (yes or no)
Girl 1
Partner - First and Last Name of girls who completed the project: (enter the names of girls in alphabetical order by last name below)
*
First Name
Last Name
City
Grade (4 or 5)
School
# of years as a Girl Scout
Plans to earn the Silver Award (yes or no)
Girl 1
Girl 2
Team - First and Last Name of girls who completed the project: (enter the name of ALL girl(s) in alphabetical order by last name below)
*
First Name
Last Name
City
Grade (4 or 5)
School
# of years as a Girl Scout
Plans to earn the Silver Award (yes or no)
Girl 1
Girl 2
Girl 3
Girl 4
Girl 5
Group - First and Last Name of girls who completed the project: (enter the name of ALL girl(s) in alphabetical order by last name below)
*
First Name
Last Name
City
Grade (4 or 5)
School
# of years as a Girl Scout
Bronze Award Girl Scout (yes or no)
Plans to earn the Gold Award (yes or no)
Girl 1
Girl 2
Girl 3
Girl 4
Girl 5
Girl 6
Girl 7
Girl 8
Girl 9
Troop - First and Last Name of girls who completed the project: (enter the name of ALL girl(s) in alphabetical order by last name below)
*
First Name
Last Name
City
Grade (4 or 5)
School
# of years as a Girl Scout
Plans to earn the Silver Award (yes or no)
Girl 1
Girl 2
Girl 3
Girl 4
Girl 5
Girl 6
Girl 7
Girl 8
Girl 9
Girl 10
Girl 11
Girl 12
Girl 13
Girl 14
Girl 15
Girl 16
Girl 17
Girl 18
Bronze Award Take Action Project Title:
*
Project Theme:
Animals: Animal Safety
Animals: Animal Rights
Animals: Pet Care
Animals: Animal Adoption
Arts, Culture & Heritage: Art
Arts, Culture & Heritage: Languages
Arts, Culture & Heritage: Historic Preservation
Arts, Culture & Heritage: Cultural Awareness
Arts, Culture & Heritage: Performing Arts
Arts, Culture & Heritage: Visual Arts
Arts, Culture & Heritage: Music
Children's Issues: Child Abuse
Children's Issues: Foster Care
Children's Issues: Infant Care
Children's Issues: Mentoring
Civic Engagement: Politics
Civic Engagement: Community Development
Civic Engagement: Voting
Civic Engagement: Advocacy
Disaster Relief: Fire
Disaster Relief: Natural Disasters
Disaster Relief: Flooding
Disaster Relief: Earthquake
Disaster Relief: Tsunami
DEIA-RJ: Diversity
DEIA-RJ: Equity
DEIA-RJ: Inclusion
DEIA-RJ: Access
DEIA-RJ: Racial Justice
Education: Literacy
Education: Career Training
Education: Career Pathways
Elderly Issues: Elder Care
Elderly Issues: Senior Centers
Elderly Issues: Dementia
Elderly Issues: Intergenerational Relationships
Elderly Issues: Lifeskills/Technology Support
Entrepreneurship: Social Entrepreneurship
Entrepreneurship: Business Development
Environment & Sustainability: Preserving Outdoor Spaces
Environment & Sustainability: Pollution
Environment & Sustainability: Alternative Energy
Environment & Sustainability: Clean Water
Environment & Sustainability: Farming
Environment & Sustainability: Climate Change
Physical Health: Fitness
Physical Health: Nutrition
Physical Health: Hygiene
Physical Health: Diseases
Physical Health: Organ Donation
Physical Health: Global Health
Physical Health: Drug Abuse
Mental Health: Self-Esteem
Mental Health: Self-Image
Mental Health: Self-Care
Mental Health: Suicide Prevention
Mental Health: Body Image/Body Positivity
Healthy Relationships: Bullying
Healthy Relationships: Conflict Management
Healthy Relationships: Communication
Healthy Relationships: Domestic Violence
Healthy Relationships: Rape Prevention
Human Rights: Human Trafficking
Human Rights: Girls' and Women's Rights
Human Rights: Immigration
Life Skills: Civic Engagement
Life Skills: Healthy Living
Life Skills: Communication
Life Skills: Financial Literacy
Life Skills: Cultural Arts
Life Skills: Global Citizenship
Life Skills: Digital Life Skills
Life Skills: Digital Hygiene
Life Skills: Digital Leadership
Military/Veterans' Affairs: Veteran's Assistance
Military/Veterans' Affairs: Veterans' Issues
Outdoors: Adventure Opportunities
Outdoors: Environmental Stewardship
Poverty: Hunger
Poverty: Homelessness
Poverty: Affordable Housing
Poverty: Fair Trade
Public Safety: Traffic Safety
Public Safety: Policing
Public Safety: Juvenile Detention
Public Safety: Detention Centers
Sports: After School Programs
Sports: School Clubs
Sports: Athletic Programs
STEM: Science
STEM: Technology
STEM: Engineering
STEM: Math
STEM: Robotics
Agency/Organization partnered with:
Number of people impacted by project:
*
Month & Year project was completed:
*
Please select
October 2022
November 2022
December 2022
January 2023
February 2023
March 2023
April 2023
May 2023
June 2023
July 2023
August 2023
September 2023
Create a 10-20 word summary that briefly describes what the girl or girls did for the Bronze Award Take Action Project. Summarize what happened and the impact. (See sample Silver Award Project Summary below.)
If possible, the summary should include:
* what the girl(s) did
* who benefited from the effort
* what was the impact
Please write in third person (i.e., Developed an education program...)
Project Summary:
*
Sample Bronze Award Project Summaries:
Educated classmates about fire safety and helping their family to develop a plan.
Planted a community garden at a local elementary school.
Bronze Award Take Action Project Photo(s)
Please upload one or more best project photo(s) that show leadership in action during the implementation of the project! (High resolution .jpg or .png file is preferred.)
Girl Scout Bronze Award Project Photo(s):
(action shots showing the girl(s) in the photo, doing the project are preferred)
Add File
Permission to Publish for Marketing/Recognition Purposes
GSOC is permitted to use names, information and photos submitted on this form for Bronze Award promotion and recognition including the annual Highest Awards Yearbook and social media recognition.
*
Yes
No
Note: Choosing "no" above means the girl or girls will not be included in Bronze Award promotion or recognition including the annual Highest Awards Yearbook and social media recognition.
Thank you!
