Shop: Uniform & Earned Award Order Form

Shop: Uniform & Earned Award Order Form

Please fill out this form to order uniforms and earned awards. If you need additional items or help ordering, please use the comment box at the bottom of this form or contact Angela Jones, angela.jones@gskentuckiana.org. Prices vary depending on size and uniform level. A receipt will be sent to the email address provided.
Your Name*

First NameLast Name
Your Relationship to Girl(s) Requesting Uniform*
Please indicate how you would like to receive the uniform.*
Shipping Address for Order*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What grade levels do you need to order uniforms or earned awards for on this order? You will only see the ordering fields for the levels selected.*

DaisyBrownieJuniorCadette/Senior/AmbassadorAdult
Email*
example@example.com
Phone Number for Order Questions*

Area CodePhone Number
Phone Number for Payment Due (if different)

Area CodePhone Number
Uniform Order Details
Please provide the uniform details below. You will need to indicate the number you need for each type of uniform and size (tunic, vest, or sash) and the troop number. You may also enter the name and number of any earned awards.

The basic components of a uniform include:
- Vest, Sash, or Tunic
- American Flag Patch
- Council Identification Set
- Troop Number
- Insignia Tab
- Membership Pin
- World Trefoil Pin
You may also add:
- Troop Crest
- Membership Stars
- Bridging Awards
Some insignia can easily be moved from one level to the next - Membership Pin (Junior - Adult), World Trefoil Pin, and Membership Stars.

For details about uniforms and the insignia placement, visit GSUSA's uniform webpage.
Daisy Girl Scout Uniform - Grades K-1
Daisy Insignia Basics - Enter the number of each item to order.
Daisy Petal Set
Daisy Earned Awards
Brownie Girl Scout Uniform - Grades 2-3
Brownie Insignia Basics - Enter the number of each item to order.
Brownie Earned Awards
Junior Girl Scout Uniform - Grades 4-5
Junior Insignia Basics - Enter the number of each item to order.
Junior Earned Awards
Cadette, Senior, or Ambassador Girl Scout Uniform - Grades 6-12
Cadette Insignia Basics - Enter the number of each item to order.
Cadette Earned Awards
Senior Insignia Basics - Enter the number of each item to order.
Senior Earned Awards
Ambassador Insignia Basics - Enter the number of each item to order.
Ambassador Earned Awards
Adult Girl Scout Uniform
Adult Uniform Insignia Pins
Adult Achievement Patches for Vest
Girl Scout Membership Star (1 per completed year of Girl Scouting)
Enter number needed for all uniforms.
Membership Star Disc - You may order the exact number you need or you can order them in a set of 24. For sets of 24, please enter the number 24.
Troop Crest (Optional)*
Please use the box below for any questions or clarifications.
Payment Information
Paying with Card? You may enter card information below for payment. JotForm is a secure platform, however if you prefer to give your information to a staff member over the phone, please indicate that below in the Questions or Comments section, and we will call you to process payment.
Shop Discount Code
Name (As it Appears on the Card)
Card Number (First 8 Digits Only)
Card Number (Remaining Digits)
CVV
Expiration Date

MonthDayYear
Date
Paying with Kentuckiana Credits? Please list all Kentuckiana Credit cards being used with the following information Name on card, card number, CVV if applicable and amount you want deducted from the card. Please note we cannot give cash back or refund card balances to a credit card. If a partial amount is used then the remaining credit will be available on the same card number.
Enter Kentuckiana Credit Information Here or Upload a File Below
Upload Kentuckiana Credit Information Here (can be pdf, jpg, or any file type:

Browse Files

Cancelof
Should be Empty:

Shop: Uniform & Earned Award Order Form

Uniform Order Details

Payment Information