Certificate of Insurance

Girl Scouts of Central Indiana
Certificate of Insurance Request Form

  • Please complete this form in order to receive from Girl Scouts of Central Indiana  a certificate of insurance for usage of a facility.
  • Please allow at least one week prior to date of usage for the certificate to be processed and sent to the facility.

Questions? Contact:

Certificate of Insurance request form

Please complete this form in order to receive from Girl Scouts of Central Indiana a certificate of insurance for usage of a facility. Please allow at least one week prior to date of usage for the certificate to be processed and sent to the facility.

Name of volunteer requesting certificate
Best way to contact:

FACILITY INFORMATION

All contact information in this section is for the person(s) at the facility you will be using for your event, troop meeting, activity, etc.
Name of facility:
Facility address:
Street Address
Apt./Ste.
City
State
Postal Code
Contact name at facility:
First
Last
Phone no. for contact at facility:
Area Code
Phone Number
Provide at least one of the following:
Will you need this certificate again for next year?
Reason for use of facility:
Date(s) of usage:

In this section you will find the steps to becoming a volunteer, a complete listing of upcoming sessions, and the resources and information to support your volunteer experience.  Can’t find what you’re looking for?  Contact us at volunteer@girlscoutsindiana.org.

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