GSSWT Troop Donations to Uvalde

Troop Number

Phone

Name of Authorized Signer for Troop’s Bank Account

(must be a registered adult member who is currently an authorized signer on the troop’s council-approved bank account)

Amount of donation:

Acknowledgement (please check box)

I Acknowledge: By entering my name below, I hereby acknowledge that the girl members of our troop have decided to donate the amount indicated above to their sister Girl Scouts in Uvalde who are affected by the recent shooting at Robb Elementary.

First and Last Name (required):

Authorization (please check box)

I Hereby Authorize: Be entering my name below, I hereby authorize Girl Scouts of Southwest Texas to initiate an ACH debit of the above referenced troop’s bank account in the amount indicated above as a contribution from the troop to sister Girl Scouts affected by the recent shooting at Robb Elementary in Uvalde, Texas.

Signature of Authorized Signer for Troop’s Bank Account (first and last name required)

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