Once you have completed this survey, you will receive a certificate by email within 4 weeks. Bring your certificate to either the Holyoke or Worcester Girl Scout Leadership Center to receive the patches earned by the troop for free, thanks to the generous support of the League of Women Voters of Amherst.

Each Girl Scout may earn one free patch.

Please note, a total of 1,000 patches are available this year.  Once we have reached that number, this survey will close.

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* 1. Troop Leader/Guardian's Name

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* 2. Troop Leader/Guardian Email:

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* 3. Troop # 

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* 4. Number of girls in troop who earned the patch. (Note: The troop needs to complete only one survey as a whole. Every member does not need to complete the survey in order to get their patch.)

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* 5. Town

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* 6. County 

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* 7. Program Level

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