Request for Gold Award Mentor This eform is used for Girl Scouts in need of a Gold Award Mentor to guide them on their Gold Award project pathway. Only Girl Scouts that have completed their prerequisites and have recently taken the GSGLA Gold Award Workshop may request a mentor. A Gold Award Mentor is a volunteer who has been appointed and trained to guide and support Girl Scouts through the Gold Award process. A mentor will work with you for the duration of your project, providing feedback on your project idea, and ensuring that you are following the Gold Award guidelines. Mentors serve as a resource and will review the materials you prepare before you submit them to the Gold Award Committee. Please allow a minimum of three weeks for a mentor to be assigned to you. You may also request a specific mentor (see below). Troop Number (Five Digits):* Which region are you in?* Southeast (Arcadia & Upland) Southwest (Long Beach & Inglewood) North (Santa Clarita & Canoga Park) Gold Award Applicant's Name:* First Last Phone Number:*Email:* Enter Email Confirm Email I have completed:* My Senior/Ambassador Journey and earned the Silver Award Two Senior/Ambassador Journeys I have not completed my prerequisities. I have completed the required GSGLA Gold Award Workshop within a year of this request.* Yes No Please complete the required prerequisites and Gold Award Workshop prior to requesting a mentor.Address:* City HiddenApplicant's Date of Birth:* MM slash DD slash YYYY Current Grade:*6789101112HiddenHigh School Name:* Graduation Date:* MM slash DD slash YYYY Date you completed the Gold Award Workshop:* MM slash DD slash YYYY Signature of Applicant:*Type your full name as your signature. Gold Award Agreement* I understand that it is my responsibility to communicate with my assigned mentor in a timely manner and commit to keeping appointments and adhering to the deadlines established with my mentor. Please list any special requests you may have for a mentor. Mentors are selected from available volunteers outside your troop or group. A mentor will be someone other than your leader or parent and must have knowledge of the Gold Award process. Special Requests:Captcha
