Smile Squad Patch Order Form

The free patch program for Girl Scouts is currently only available to girls in the Girl Scouts of Silver Sage Council.

Contact Information

First Name *
Last Name *
Phone *
Email *

Shipping Address

Address *
City *
State *
Zip *

Troop Information

Council *
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Troop Number *
What day did your troop complete the Smile Squad Girl Scout Patch Curriculum? *
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Indicate the number of scouts who earned the patch.

Daisies:
Brownies:
Juniors:
Cadettes:
Seniors/Ambassadors:
Total Number of Girls:

Additional Information and Feedback

How did you hear about our Smile Squad Patch Program? *
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Other:

Please select what activities your troop completed from the category in the drop down menus below

Discover: *
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Connect: *
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Take Action: *
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How satisfied were you with the educational component related to this patch? *
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How valuable do you think this information is in your scouts’ lives? *
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What activity from the curriculum was the most meaningful for your troop?
How did your scouts' behaviors change since earning this patch? (Check all that apply) *
Other
Do you have any additional feedback to share?
Submit

Questions?

If you have questions, need assistance, or are interested in receiving information about the Delta Dental of Idaho's oral health programs and activities, please contact Community Outreach at co.gsss@deltadentalid.com.