GSK Kentuckiana Credit Swap Form

Kentuckiana Credit Swap Form

Thank you for submitting your Kentuckiana Credits that you would like to swap for reimbursement for completed membership, events, day camps, or property reservation payments. This email will serve as your receipt. Please allow 3 weeks for processing. If you have any questions, please reach out to us at CustomerCare@gskentuckiana.org or 888-771-5170.
Online Transaction Reimbursement
1. Complete online transaction (membership, gsEvent, or property reservation) with a credit or debit card.*
2. Fill out and submit this JotForm.
3. Council will deposit the credits amount into the account. Please allow three weeks for processing.
4. Form must be submitted by the expiration date of the Kentuckiana Credits.
Gathering What You Need
1. Bank Account Name / Number (Cancelled Check, if New)
2. Receipt for Online Purchase* (Need help with a receipt? Contact Volunteer Care at 888-771-5170.)
3. Kentuckiana Credits Numbers & CVV
*Volunteer-Led Camps - No prior purchase is necessary.
Name of Person Completing this Form*

First NameLast Name
Phone for any Questions During Process*
Please enter a valid phone number.
Email to Send Notification of Deposit*
example@example.com
Please select the group for whom you are submitting this form. Upon selection, the remaining fields will be personalized below.*

TroopService UnitAreaVolunteer-Led Camp (Day Camp, Camporee, or Mini Camp)Other
Troop Number
Service Unit Number & Name
Area Number
Volunteer-Led Camp Name
What is the name of the account to deposit funds into? (Examples: Troop 40206, Service Unit 800, Area 30, Area 30 Day Camp, etc.) You may also include the account number for clarification purposes.*
Would you like this amount to be held by the council and applied to your balance due or transferred to the account now?*
Is Bank Account on File?*

Bank account information IS on file at Girl Scouts of Kentuckiana.Bank account information IS NOT on file at Girl Scouts of Kentuckiana.

Please attach a copy of a check or official bank paperwork to confirm account.*

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Attach Receipt - Receipt must show purchase greater than or equal to the amount of credits that you are requesting to be swapped. The SWAP will not be processed without the receipt. *

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I want to submit my Kentuckiana Credits:*

Type the needed information for each credit.Attach a file with the credit details.
Kentuckiana Credits - Please upload a clear image of the table with the credit details. The image must show all columns. You may also simply upload a copy of the email or a spreadsheet with the credit details.*

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Kentuckiana Credits - Please fill out each column of the table.*
Use this space to provide more details, if needed.
Date Of Processing

MonthDayYear
Date
Should be Empty:


Bank Name
Routing Number
Account Number


Description:
Date:
Amount of Purchase: