ࡱ> hjg@ 0bjbjFF xx,,RRRR(8t|$(`L`d8l-//////$ R(#SQ^SRRR88--V@= h;4% $01 # #=RRRR#=>,$2SS(( $"(( Instructions: Fill out this form and forward it to your field executive to begin a discussion with the council about your interest in offering a program activity that addresses a sensitive issue or an activity that is not listed as an activity checkpoint in Safety-Wise. 2. Your field executive will respond within two weeks. Troop/Group #  FORMTEXT       Leader/Advisor Name  FORMTEXT       Leader Address  FORMTEXT       City  FORMTEXT       State  FORMTEXT       Zip  FORMTEXT       Girl Scout Membership Year  FORMTEXT       Service Unit Name  FORMTEXT       Age Level:  FORMCHECKBOX  D  FORMCHECKBOX  B  FORMCHECKBOX  J  FORMCHECKBOX  Teen Girl Scout 11-17 High Risk or Sensitive Issue Topic:  FORMTEXT       Please give a brief description of the activity you are proposing.  FORMTEXT       Who has been involved in identifying this interest/need?  FORMTEXT       If you already have a facilitator/consultant in mind, please indicate who, their affiliation, and if and where you have observed them addressing this or a related topic.  FORMTEXT       Do you think you will have any girls or parents who might not be interested in participating in this activity?  FORMCHECKBOX  Yes  FORMCHECKBOX  No If so, why not?  FORMTEXT       Request Prepared  H     H V W X b c    , 8 : < P 꾴ydZPZh4-`CJOJQJh=|CJOJQJ)jh4>*CJOJQJUmHnHu*jh3ah!>*CJOJQJUjh3a>*CJOJQJUh3a>*CJOJQJh3aCJOJQJh>CJOJQJh|,CJOJQJhZ{hZ{6CJOJQJhZ{CJOJQJh4(CJOJQJhlCJOJQJhl5CJOJQJ  G H d J d f 0*s0*s0*s0*s0*s0*s0*s0*s0*GV0*GV0*s0*^0*s0*s0*^0*s |)@xgdpj |)gd3a Hxgd3a  !|)@@xgd3a  !|)xgd3a @ |)gd3a 0hgd> @ |)gd4-` & Fx*/00P R T ^ ` b d        " 6 ںںںںvںں`ںں*jh3ah!>*CJOJQJU*j\h3ah!>*CJOJQJU*jh3ah!>*CJOJQJUh3aCJOJQJh3ah4-`>*CJOJQJh3a>*CJOJQJ)jh4>*CJOJQJUmHnHujh3a>*CJOJQJU*jth3ah!>*CJOJQJU%6 8 : D F H J j  ںںںںlںbXhlCJOJQJhj;CJOJQJ*j,h3ah!>*CJOJQJU*jh3ah!>*CJOJQJUh3aCJOJQJh4-`CJOJQJh3ah4-`>*CJOJQJh3a>*CJOJQJ)jh4>*CJOJQJUmHnHujh3a>*CJOJQJU*jDh3ah!>*CJOJQJU  4 6 8 B D ` b d n p 2 6 : ~o`TGh3a>*CJOJQJaJh3aCJOJQJaJh4(h4(CJOJQJaJhpjh4(CJ OJQJaJ hpjhlCJ OJQJaJ h>CJOJQJ'jh4h4CJOJQJU'jh4h4CJOJQJU'jh4h4CJOJQJU'jh4h4CJOJQJUhlCJOJQJjhlCJOJQJU: < P R T ^ ` b d f ᢓxxfYAffY.jhpjh!>*CJOJQJUaJhpj>*CJOJQJaJ"jhpj>*CJOJQJUaJh4(h4(CJOJQJaJh4(CJOJQJaJhh4(CJOJQJaJh3ah4(>*CJOJQJaJ-jh4>*CJOJQJUaJmHnHu.jph3ah!>*CJOJQJUaJh3a>*CJOJQJaJ"jh3a>*CJOJQJUaJl~@   "$.ָ|m^R:|.jhpjh!>*CJOJQJUaJh|,CJOJQJaJh|,h|,CJOJQJaJhh4(CJOJQJaJ-jh4>*CJOJQJUaJmHnHu.jZhpjh!>*CJOJQJUaJhpj>*CJOJQJaJ"jhpj>*CJOJQJUaJhZ{CJOJQJaJh|,h4(CJOJQJaJh4(CJOJQJhpjh4(>*CJOJQJaJ 46((@)B)))))Z*\*0*s0*^0*s0*s0*^0*s0*s0*s0*^0*s0*^0*s0*^0*s0*j0*j0*j0*s0*^gd> >,؀gd7 |)gdw6 |)gdw6 (#|) t"|)gdw6 |)@xgdw6 |)@xgdpj.0246"$@BDZ\xz|~ŶxbV>.j.hpjh!>*CJOJQJUaJh|,CJOJQJaJ+jh4h4CJOJQJUaJ+jFh4h4CJOJQJUaJjhpjCJOJQJUaJhpjCJOJQJaJhZ{CJOJQJaJh|,h|,CJOJQJaJhCJOJQJaJhpjh|,>*CJOJQJaJhpj>*CJOJQJaJ"jhpj>*CJOJQJUaJ((( ( ( ("($(.(0(2(B(F(H(J(^(ɹt^tItt)jh4>*CJOJQJUmHnHu*jhw6h!>*CJOJQJUjhw6>*CJOJQJUhw6>*CJOJQJhCJOJQJUhlCJOJQJhCJOJQJh|,CJOJQJhpjh|,>*CJOJQJaJhpj>*CJOJQJaJ"jhpj>*CJOJQJUaJ-jh4>*CJOJQJUaJmHnHuby:  FORMTEXT       Position:  FORMTEXT       Date:  FORMTEXT       Best time to contact:  FORMTEXT       Phone #:  FORMTEXT       Email:  FORMTEXT       Alternate Phone #:  FORMTEXT       Date Received at Office: Date Approved: and returned to leader. Field Executive s Signature: Girl Scout Council of the Mid-South   High Risk or Sensitive Issue Approval Request Form  Mailing Address: P. O. Box 240246, Memphis, TN 38124-0246( Phone: (901) 767-1440 or 800-727-8104 Fax: (901) 797-2183(E-mail:  HYPERLINK mailto:info@gsmid-south.org info@gsmid-south.org(www.gsmid-south.org Updated 06/04  FILENAME \p Document1 4 Page 2 of 2 Mailing Address: P.O. Box 240246, Memphis, TN 38124-0246 f& Phone: (901) 767-1440 or 800-727-8104 Fax: (901) 797-2183 f& Email:  HYPERLINK "mailto:info@gsmid-south.org" info@gsmid-south.org f&  HYPERLINK "http://www.gsmid-south.org" www.gsmid-south.org 1/07 Web  Word File Template ^(`(b(l(n(p(x(|(~(((((((((((((((((ںںںsi_Uں?*j hw6h!>*CJOJQJUhw6CJOJQJh|,CJOJQJhHCJOJQJhh|,CJOJQJaJhw6hl>*CJOJQJ*j hw6h!>*CJOJQJUhCJOJQJhlCJOJQJhw6>*CJOJQJ)jh4>*CJOJQJUmHnHujhw6>*CJOJQJU*j hw6h!>*CJOJQJU(((()))))),).)0):)<)>)@)B)N)P)R)T)h)j)l)v)x)z))))))ƼЦИu_u*j hw6h!>*CJOJQJUhw6CJOJQJhCJOJQJhh|,CJOJQJaJhw6h|,>*CJOJQJ*j| hw6h!>*CJOJQJUh A CJOJQJh|,CJOJQJhw6>*CJOJQJ)jh4>*CJOJQJUmHnHujhw6>*CJOJQJU )))))))))))))****&*(*Z*\***ںukakuVkuKuAuKh>CJOJQJh>>*CJOJQJh3>*CJOJQJh,CJOJQJh3CJOJQJh>CJOJQJh,h3CJOJQJaJh,h,CJOJQJaJh,h>CJOJQJaJhw6h|,>*CJOJQJhw6>*CJOJQJ)jh4>*CJOJQJUmHnHujhw6>*CJOJQJU*jh hw6h!>*CJOJQJU\*******,++++d,H----z.0*s0*^0*^0*^0*0*0*Y0*Y0*0*v:$ (#|)a$gd2|{ !|)  !|)<gd"Iz$a$gd  P l$a$$ (#|)a$gdZ{$ #|)a$gd7 R&|)gd7*********+++++,,,,,,,,Ǽ{o`Qo`o@o jh-B*OJQJUphhz,h-B*OJQJph jh-B*OJQJphh-B*OJQJphh-OJQJh-h-5CJ0OJQJ)jh-5CJOJQJUmHnHu)jh-5CJ0OJQJUmHnHuh-5CJOJQJh,hCJOJQJaJh,h7CJOJQJaJhCJOJQJaJh>h>>*CJOJQJ,,,-- -F-d-f-------*.,...ۼ}m[WL?L?h%Gh2|{OJQJ^Jh%Gh2|{OJQJh-#jh"Izh-OJQJUh*h4OJQJhmHnHu*jh-OJQJUhh"Izh-OJQJh jh"Izh-OJQJUhh-OJQJh-B*OJQJph jh-B*OJQJphh-0J>*B*OJQJph jh-B*OJQJUph&j h-B*OJQJUph.. / //6/8/>/@/////////////00000~z~v~rch,hCJOJQJaJhO}hlh4h-h2|{h-OJQJ^Jh2|{OJQJ^J h%Gh2|{CJOJQJ^JaJ'j h%Gh2|{OJQJU^Jh%Gh2|{0JOJQJ^J'j h%Gh2|{OJQJU^Jh%Gh2|{OJQJ^J!jh%Gh2|{OJQJU^Jz.////000000*v:0*v:0*^$ (#|)a$gdZ{  !|)gd=|$ (#|)xa$gd2|{ .&P:pit/ =!"#$%en@6"6!>[<(PNG  IHDRqlgAMA IDATx홢:`v `*c2T V V Sc #9^>B0.,s~8;ߢ(RYbvB,t:pRu  "  f,eYD$`XABQeYooorMIDQy|aA+34MqeOσ(r uF#BR!z$|.JfYF](,{V󹮛i ի A)%8B\Bhԓ 9OӴsss]( ̝]<`)²$BwY`@#!HĐm( lfp<t:=??B5-jt:.bq۶}?_.Q1 N BˋR4",aEQT|{A҃H4 :GÜPT":$z" ,KIА.ާ˲DZ,dRhА,:aY~<ϲ,!yJf/ l juG"!˲d,q4Ms<c5Ձ JӓR˕[9Jl6TN wRDN8Sn^P}$qĥz]BG[ha_P> $cZU \Y.X f\\w4qD{E0͑"hn[3 Tw4p]aYVEjvsL0cƔ|@$8lIy,1 `8!g (RǪZ܊1 8` 2-$48j&H 9}}y -ZiAWhYABDpJX cЦ}'FN']UbaPcWtCcP(Rwv뒎x L $ݏ r?B R[9dԻ PA)ppmsoz] !\R*Ivzly^тRT -} (˒RJ)m!(7Bg:#z$ceY*EX$ɭ^h$(nl.7.}_֨(B t,˷.p]7(xnX{=IUV,J:8jNimV5$I(_B[{(EQ(ߑ>B$AhG<1;Qq|K(d)˲( pX.J~V͡fYfCo۽! QF= t4k!DQywwPn"H@ciU`25A[Mڅaא !<|&o[7 pf(ۤQhQnS"Z1BFtA(,!n<˲D A*"MN#sy9h=AsNuGY>Ћs.՟߭rsIh[AQX8n#}{E8NeBe1Ke}M^-u`cyAwk$4ǝw6Sc˯AE8FAС C!Q3@2n=>>"? A8?;z۹#p8(8ZKYYAap9;Uar T)H!:bd<DDF"m6!wMdY;(Xw)n Ш, ! ?RH)t8Ṍ1Gt:1!dh&5ڻl:I.=0 \. ? Eg۶­ !ՂrE@#t`S~X5sԊ\a V$///¢˻."JiQaRMA0QJtj$( +>0TosC. !K pA`aRI>l* }$;z4ML8NTU8NJz%!zW]7ʺN1ư$4Mv_m;IBȏR*oJ镧+vWVr_~J, ʹ+n:?9"m{4VF?zfq۶}0Ţb^_9?|l۞NQI!>( C%K⋷x^{m91wAsPmnBmwFh_@wD}(Rbe5Sֹ -kf6AqSx#oABѿ[64UTPݔj)9obkcHo #LOQ;F|y^ooo5436˲(:%踓|arQJ)/+ӞA$I/UA¶mcsƘ1&R!'|<ϓ[?[/-s\sιvfJO5p/oCy1[ߤ_\}0T& w fancaZ).+r^OMnѨ ˃f U`xiZM& a8LއzNaV_KO&je ~}$l6|Gt:]׆\;6DŽxT5G^cm3| kb"5Th$*2ЦbDZo ۶8^,mZ[?L~ɿ{,D%goY6!)lqf3Z6"U`7ѡTsוmJ)`{tU=x/s"HT4gO&W4}sˏ[~$ڡ{>Ţ-Ͳ-4MSy¥v]Ue4n8N_ߡ!P404r{ʇ|lSJ(zxxX.}f3ǩD!,<m3#-`7Q 8$Ksߚ;SltwvZSƷ@'"MSY]dxzzҵ{tz}}<q+aZ`3"9WFJ6gxP]t:Ţ"=ex<]A3[j{$8Ihd!"IgCڏ lֵYӯb䊬iLnRmiLK1áߝBBs8Xܦnu8(H@U@VӮ!HL@0n~T0f)sCWExhz<1E9cʆFִl5Ԑ3-Uƒm*KaEQ| ۶gT)al=o꤄z'ZeYbDSE ,䦇ډQWMp{:] ?*Oi̜Z`$ &{ZxVLV ԶQ靠jtt3ԶBLy9YߨI,0|EQ.-P1%F#*4MgY4G>zc®۶@/BQ>é}v>U0k ^:wl6>]Z""c/i-$FihN9Sq0JaH#z#sVM2K`,aD23UԳ $Ibl$LfaEQW셸f3p\a1G B`ڭku},c؎ʻ_S,Eƣ$~>ԜdYQ>J*Fһg V8u]y.e&9sd;5!3ٵԃ!!KRw)?>?S IRB@k),p+!i]]]l!݊cGuZw?Ƙv>}G%GYœ$ XҲbsNPu(7$iz\.K0y(Mz\.=PƁkȶ ǹ|djW7A[2E*je} #G¶E!3m݅qg45ۚaB]sNTVSV!|IέO:X0,KV,b !l&IbH}Wx,PQUIs)u]2'EX~y$w,RmEaε51 o2!m7fIӔ~ih}ITeYn}Y BPJ˲lgYV$1F(tt:狢h̬( ,nJyw'2NPJ/8\fY,[, ?mTa}%q]Wa1| %_lԷ٨ܲ0 xߕ>[>?~Nr;3Wq 3{#X@G8v8p~m9T !^gv/B꫃e ~$(m^PeEqK 1'i Alm݁\E6!MӶ-:`d$I(}…0G!g/GH?YM;#!8ua߅2f,C9(gxHe#ab^YI_-vGMǃb*$de̜RH@Scf$ vRH|S+D64:SߠLjzȥaPsI/0KP$֞5'cqO$"*VLPK(r:6n7Azـl6P NزG"@ƢČT . uAKI$3" C­b * H4,@GNB(s1$p>QrČTdEJ$!03& $I89za"7b:es>NV`䇅 y -UUqy/?Yy 8y~,k4DH(/|>\CdB4ͅn%qz^l^b!|{t]Otr8Nc(!I+s&q֮RH,`3gqB2O.a~8^ײ.YL8c\.+:&R4(]4Itd *^$w˲h>dYBb3*iHI 'VxЃm{gô4MN:[JI^g+j F̹܋m$$"hO؈)ض=%eF4Utj^GTiPLOI p߹^anb)Bb*²,nui"wAn6"#`YN#'s()WUȮ4˵}!` /]7ͼ"LUD0 fјtH`=t],  %$8iWO($@n=S/*y~jЄ6 2~>lB~^8R/TZB UU40ԘMh: X~qUU9BԥfYFY 1;,꠳Dh$?]>??Jp$"!`pX--i;M=F4}{rHT"0 DZ, ܕ(TL Y2]iNf!4i{g B/i󼹫CjgaVv.$ ay8.D_1yFY2z 'e1ɊERmy jyvjqrrd<24kt]?r19r)V0 0z#"yǠEvoooKp"hmc"&窤TK^Y?B0'4PU,2 <ϲ8N͌y Bx]ETUyF=4*|ȰA ^d$exAIDAT xAԋiijBrPE>F̘Wx*²,m}`zʠD D$'桬g>_B (#x*v=iE6):d^D"0A qCm^RH4H!$؇ݳW=y]0 ^y>waYL_4vNL׫ '{ u͉'@D8\~"]Kq8.,g2klưè~;TDǿQi|#(4dlWQuvMCR{BHYx3A0Øj o)HJ_,4=se Ϭ(Je?$ nFpGǏˉ T˲n﫪mQ=kH2{rB)p? 8ϖeɸD˜4M ~$eA JN'fP^u}HLN=,s4 P9u]}}k]@rYAUU'OůxUU 苌HOQ۶Ã,y`P.w `_#"ЁL.ewb4;èc!c^8fP`x.`&5݁TZ׵eY2iU"an<"W4:N *%&Fp*.MTJӴ(ʲȲ3?N (˒A@_0~Y1xd?9c0 "۶LȈD_dDb$e~w<1Ol#J;V`{# 봫  M^ܢmOvYhڹB]f B}e XZ J86OΘ[nUUYJ,)$"HSi( wO>1h ƦO<$IEQ@ݴ(  &h C1^| #xsUCP+.=9lHKx*Bg8¦R4Mʾ#D_Ýu C0\fݝG%l{ 6uk2$1'BBU\ Xj֖mJe݂x0S 4죘6 )$"CǓeG/U vT] {BBC:9I6? ̊n2,˚Q#eY6o`w_qo)gP`0N64m"ZcxF > 'fӀ1'$mǸ(AY}|Mc#OmcuQ#3 4+'k~JRehKͲ~ s@x\/;م㙤BA^,bc ]OHt7lng{Q[ H!deȲa1,0yǔZ/C=̀]YDJj]H<9?]5^1vh)[BD(7^>~ኢF='D,$ژ.Uf;Q&`8u c{=RYICCI#ޅFQD+>dfGxQlpASUO:kz? L³szms5kiOw1q1!i4u:/ ]OHT5x&PL|x zۭ뺯%]nT=0TӴ)H0^Gt,M!M:Ԛ?+$4M٘fHQۨDTc|^S)t7ڕ^$V,^f*A.fSw߄H-H!xBJ<\]/1ɴk6ijhimA$Ir<Yjjm6*]mu1j=5 0,XN% ]OHkBK \>#uԋwa3bJ?"6/)b6B3!l[sxCUUS?B'l~m|~RxvWfMxujYi@۽(4$"c$S XjӌF󓾇e]KB,F0# 7T2KLL}$桭̖ z.x5 `|Y$H .&$Ra Ayl#WK`_DD t'$ioIEQ]ʲ9!X>w: N )?n0>RHtA0! <Aʤxm*UA{Js%$nSXDu/o Cvu *FW9r<Tw I;RH -H.;pxq,}SaaBĻt7yuW๯G[7ag4m 8w(@R0 p1:!=i;i2tEE3M0`L`B-,?wY/uKhބči&^4m@!!]?zdfU:lۑzGOjbPUU1A`91`4`B-!I"WX@^1uY:7š-w7?mwy6n99{a<3~/]υi0~RHtA0!1!=O( ~vc3 1VMiڳSH۪w3!aAQA?]8 fu(uݾ_dY>.!A0fB Ap 0;)M~YͭnY1x[puz(L}?۶""ա,vєh,7ʲIQU})!F$)> iRI!D_{ww&`ɽ܁ D*@TSNT0!X` B*\N81\ɏG`>}y_V]s1 2I]PNO8oʁ{#xsX.(b,Qc^tȲl:lvz=ȞR(s,84B)u"WiyG]=_QnN?X`ߑsY'V'ӵ>#DZw'(Hwnjcϟo6{oϟ?-s lӧO Geyyose2mX;VuM ,dxZ,LFfo߿>_[ڶms` .2}uS_~ [RaK4M۶|TUUy_7MuGRey񯿊 x !@u ;6}o~>yo%7|f_c״ &;8Wi߾~($R.v옃z<"[cz 8:窪 X 1IumH% !q|aFSJE 9ǟ nÎ5<<<,!D w(6˲!J#,k$׹CF"&Inlj" @Td$,4>|cRƘ7!@bl[9Zp@lstlu6hf((#C v>j [hGl6F`spAAeY~%`ZXCFBJYE EcF"R7NCF" PJYkOOJ{k!1&MӨG!#$r^,$$I"0d$$qi/m^ $8,G^O $Vk_Bnn\L6yi^Uō# *#5Mswww,3<眔`&\Ѭ2^Y>x* 5f#"03ԫ euK4ޒDyf$O%7&[0@"=I*BkXι[6 QcCz]וeyk#^Z/S& S׵1fhK)kBm6s b#Rmۆ]T bs$F|CQL?~ Ui*B*H@2H H Balloon TextCJOJQJ^JaJh h h B zh GH :Zopi~=RSJKLM0230>?C a b c d e f i 0 0@0@0@0@0@0@0@0@0@0@0@0@0@0@0x@0x@0@0@0x@0@0@0@0@0@0x@0@0@0@0@0@0@0@0@0@0@0 @0 @0@0@0@0@0@0@0@0@0@0@0@0@0@0@00@0@00r@0@0@0j rGH :Zopi~=RSJKLM02?C a i @0@ 0@0@0@0@0@0@0@0@0@0@0@0@0@0@0@0@0@0@0@0@0@0@0@0@0@0@0@0@0@0@0@0@0@0@0@0@0 @0@0My00Oy00My00My00Oy00 pXo@0@0Y@0 0b(r~P 6  : .^(()*,.0 \*z.0  0 Wci%17MY_o Zfliu{!=IOiu{ 5AGh FFFFFFFFG G G G FFFFG G FFFFFFFF(=aoy 5JNxXXX   ?b$"6!>[<(H60B2$;|HRjX[x*2$bȅw%4MP'@ 0(  B S  ?~f(  \B  S D>" \B  S D>" f  C (AHBlack1" h $&{ 0* 5` u0*5Text1Text2Text3Text4Text5Text6Text7Text8Check1Check2Check3Check4Text9Text10Text11Text12Check5Check6Text13Text14Text15Text16Text17Text18Text19Text20X&Np[j>j6i  j8`m|"P| Hi 8 9 L: ; LVVaai ]]hhi 9*urn:schemas-microsoft-com:office:smarttagsplace8*urn:schemas-microsoft-com:office:smarttagsCity c e i c e i Wj%8M`oZmi|"=Pi| !4I/0=?` a a b c e i b c e i r.#100[j #@kd~i ^`OJQJo(-hh^h`. 0^`0OJQJo(-[j#@kr.#-,-Y -= A 5 2W|,j;uF%GHV7L.-W4-`3ait8x"IzZ{2|{l!7>9pjOP5O}4(/=|,7%Tn3>w6YY4 pi IA0@dij ddLdddddh `@` ` ```(UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma#hSfSf`!#;!#;!r4d3QH ?YY#ANNUAL TROOP/GROUP FINANCIAL REPORTBonnieBonnie   Oh+'0@ P\ x   $ANNUAL TROOP/GROUP FINANCIAL REPORTNNUBonnieTonnonn7High Risk or Sensitive Issue Approval Request TemplateBonnies1nnMicrosoft Word 10.0@Ik@8;ss@S4@V*4!՜.+,D՜.+,d  hp  Girl Scouts of America;#O $ANNUAL TROOP/GROUP FINANCIAL REPORT Title 8@ _PID_HLINKSAH # http://www.gsmid-south.org/$]mailto:info@gsmid-south.org$]mailto:info@gsmid-south.org  !"#$%&'()*+,-./0123456789:;<>?@ABCDFGHIJKLMNOPQRSTUVXYZ[\]^`abcdefiRoot Entry F <4kData =1TableE#WordDocumentxxSummaryInformation(WDocumentSummaryInformation8_CompObjj  FMicrosoft Word Document MSWordDocWord.Document.89q