Highest Awards Support for Special Needs Request "*" indicates required fields Some Girl Scouts may require additional support (IEP, 504 plan, or other) to complete their Silver of Gold Award. If this applies to you, please let us know by completing this eForm. We’re here to support you and will follow up with steps that are specific to your needs. Note: All information will remain confidential with your council’s Highest Awards staff and volunteer team, and will only be used to support you. Any documents you provide will be destroyed upon completion of your Silver or Gold Award.Which award are you needing accommodations for?*SilverGoldName* First Last Email* Enter Email Confirm Email Phone*D.O.B* MM slash DD slash YYYY Graduation Year* Troop Number* City* City Region*Southeast: Arcadia / UplandSouthwest: Long Beach/InglewoodNorth: Canoga Park / Santa ClaritaLeader's Name* First Last Leader's Email* Enter Email Confirm Email Primary Caregiver's Name* First Last Primary Caregiver's Email* Enter Email Confirm Email Primary Caregiver's PhoneDo you have an IEP, 504 Plan, or other? Yes No All information will remain confidential with your council’s Highest Awards staff and volunteer team, and will only be used to support you. Any documents you provide will be destroyed upon completion of your Silver or Gold Award.Please upload your IEP, 504 Plan, or other related documents.* Drop files here or Select files Accepted file types: jpg, png, gif, heic, pdf, doc, docx, Max. file size: 20 MB, Max. files: 5. Describe what types of accommodations and support is currently provided at school.*What accommodations are needed to support you in pursuing your Silver or Gold Award?*Do you have another special factor(s) that your council’s Highest Awards team should be aware of as you pursue your Award?*CAPTCHAUntitledFirst ChoiceSecond ChoiceThird Choice
