EmailMe Form - GSOC Silver Award Intent Form

GSOC Silver Award Intent Form

This form is for Girl Scout Cadettes in grades 6-8 who plan to START the Girl Scout Silver Award project during the 2023-2024 Girl Scout membership year (September 30, 2023 - October 1, 2024).

The information submitted will be used by Girl Scouts of Orange County (GSOC) to provide support for the project and ensure project plans meet required guidelines.

Instructions

Girl Scout Cadettes submit this Silver Award Intent Form - and attach a copy of their completed Girl Scout Silver Award Project Proposal (fillable PDF) - after completion of a Cadette Journey and at least 30 days before they intend to put their plan into action to earn the Silver Award.

An individual Girl Scout or a project team (of up to four Girl Scouts per project) should work with their Girl Scout Adults to complete and submit one form per project.

Responses should reflect girl-led project planning using the Girl Scout Silver Award Project Proposal and the Cadette Workbook for Earning Your Silver Award.

Tip: Create responses in a separate document to copy and paste into the Silver Award Project Proposal and into this GSOC Silver Award Intent Form.

Contact Info
Name of Girl Scout submitting this form *
First Last
Email of person submitting this form *
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):
Troop/Group Leader's Name *
First Last
Note: Individually registered Girl Scout Juliettes enter parent name.
Troop/Group Leader's Email *
Note: Individually registered Girl Scout Juliettes enter parent email.
Adult Girl Scout Volunteer Supervisor *
First Last
Note: Individually registered Girl Scout Juliettes enter parent name.
Adult Girl Scout Volunteer Supervisor's Email *
Note: Individually registered Girl Scout Juliettes enter parent email.
Service Unit (SU #) Region *
Current Girl Scout Year *
Remember: Girls must be registered Girl Scouts to work on and earn the Girl Scout Silver Award.The new Girl Scout membership year begins October 1.
Girl Scout Cadette(s)... Future Silver Award Girl Scout(s)!
Project will be completed by: *
Number of Girls who plan to complete this project: *
Note: An individual Girl Scout or a project team (of up to four Girl Scouts per project) can earn the Girl Scout Silver Award.

If girls are working as a team (up to four Girl Scouts per project team), list the names of up to four Girl Scouts who will work together to complete the project or if a Girl Scout is working solo, list the name of the individual girl below. Pro tip: Enter "NA" or a blank space for all unused fields. *

	First Name	Last Name	City	Troop Number	Grade (6, 7, or 8)	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

Each girl listed is a registered Girl Scout for the CURRENT Girl Scout membership year. *
Yes
No
Not sure
Prerequisite Cadette Journeys
Which Prerequisite Cadette Journey(s) did you complete? (check all that apply) *
aMAZE
Breathe
MEdia
Outdoor Journey
Think Like an Engineer
Think Like a Citizen Scientist
Think Like a Computer Programmer
When were the Cadette Journey(s) completed? (check all that apply) *
Grade 6
Grade 7
Grade 8
Silver Award Project Plan
Project Title: *
Note: If a project title has not been determined, enter "Project Title TBD."
Estimated Start Date *
MM / DD / YYYY
Estimated Completion Date *
MM / DD / YYYY
1. The issue the project will address is... *
(Please include a 3-4 sentence description. See the Cadette Workbook for Earning Your Silver Award, Step 4.)
2. It matters because... *
(Please include a 3-4 sentence description. See the Cadette Workbook for Earning Your Silver Award, Step 4.)
3. My target audience (who is going to benefit) is... *
(Please include a 1-2 sentence description. See the Cadette Workbook for Earning Your Silver Award, Step 4.)
4. Community members I contacted or partnered with to research my issue and find the root cause (See the Cadette Workbook for Earning Your Silver Award, Step 3.): *

First Name Last Name Organization How might they help?

1

2

3

4

5
5. A root cause of my issue is... *
(Please include a 1-2 sentence description. See the Cadette Workbook for Earning Your Silver Award, Steps 3 and 4.)
6. My team's project idea is... *
(Please include a 3-4 sentence description of your project, including the desired result and how it addresses the root cause of your issue. See the Cadette Workbook for Earning Your Silver Award, Step 4.)
Tip: Check out the "Take Action vs. Community Service" section of the Cadette Workbook for Earning Your Silver Award to make sure your project is truly Take Aciton.
7. How will you create a plan to make your project sustainable? (check all that apply)
Create a permanent solution that can be used after the project is complete.
Educate and inspire others in the community or within Girl Scouts to be part of the change.
Advocate to change a rule, regulation, or law and encourage others to join.
Specifically, my team will plan to make the project sustainable by... *
(Please include a 3-4 sentence description.)
8. Please provide a description of your team's leadership. (See the Cadette Workbook for Earning Your Silver Award, Steps 2 and 5.) *

First Name Last Name Leadership Roles Responsibilities

1

2

3

4
9. Silver Award projects sometimes require money or nonmonetary donations of goods. If your project requires this, then please estimate supplies/donations needed and potential costs. A budget worksheet with actual supplies and costs will be required with the Final Report. (See the Cadette Workbook for Earning Your Silver Award, Step 5 and the template pages.) *

Supplies/Donations Cost (even if $0)

1

2

3

4

5
10. Check "Yes" to indicate you are aware that each individual member should spend approximately 50 hours working on their Silver Award project and will maintain a time log. (See the Cadette Workbook for Earning Your Silver Award, Step 6 and the template pages.) *
Yes
11. Try it: Describe how you will try to make your project measurable by sharing the goal your team set to measure your project's success... *
(See the Cadette Workbook for Earning Your Silver Award, Step 5.) [Optional]
12. Try it: Describe how you will try to make a national and/or global link... *
(See the Cadette Workbook for Earning Your Silver Award, Step 5.) [Optional]
The project theme that best matches this project is:
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
Girl Scout Silver Award Project Proposal: File Upload
Girl Scout Cadette(s) complete the fillable PDF and upload a copy as part of this GSOC Silver Award Intent Form submission.
This is a copy of my completed Girl Scout Silver Award Project Proposal:
Upload your completed copy of the Girl Scout Silver Award Project Proposal. Get the fillable PDF at https://www.girlscouts.org/content/dam/gsusa/forms-and-documents/members/highest-awards/GSUSA_Girl-Scout-Silver-Award-Project-Proposal.pdf
Thank you!

	Supplies/Donations	Cost (even if $0)
1
2
3
4
5

Contact Info

Girl Scout Cadette(s)... Future Silver Award Girl Scout(s)!

Prerequisite Cadette Journeys

Silver Award Project Plan

Tip: Check out the "Take Action vs. Community Service" section of the Cadette Workbook for Earning Your Silver Award to make sure your project is truly Take Aciton.

Girl Scout Silver Award Project Proposal: File Upload

Thank you!