Numeral Guard Request

Numeral Guard Request

Please complete the form below to ensure that we have accurate membership years in our database for Numeral Guards. Numeral Guards and certificates for distributed annually during our Awards Ceremony in June. Girl Scouts of Greater Atlanta provides numeral guards for adults with 30 or more years of Girl Scout Membership. Pins are available in 5-year increments.
Member Name *

PrefixFirst NameLast Name
Member Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
E-mail
Number of Years as a Girl in Girl Scouting *
Number of Years as an Adult in Girl Scouting *
Mail Numeral Guard to:

Same as above
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail
Should be Empty: