Volunteer Application

This application is not a membership or training registration form or application for employment.

Application Date

YYYY

Name

First

Last

Address

Street Address

Apt./Ste.

City

State

Postal Code

Primary Phone

Secondary Phone

Email Address

I am

New Girl Scout volunteer

Former Girl Scout volunteer

Lifetime Girl Scout member

Interest Indicator

What is your volunteer availability? (check all that apply)

Mondays

Tuesdays

Wednesdays

Thursdays

Fridays

Saturdays

Sundays

Time of days?

Morning

Evenings

Length of time available to volunteer?

Ongoing

One time

Short term

Occasionally (e.g. holidays, special events)

Troop volunteers: if known, please answer, if you do not know please enter N/A:

School and / or Troop #

Leader, Coleader, Product Sales, Day Camp ,Parent Helper etc.

Position applying for (Leader/Coleader, Product Sales, Day Camp, Parent Helper etc.)

With which grade level(s) (if relevant to position) do you prefer to volunteer?

Daisy (K-1)

Brownie (2-3)

Junior (4-5)

Cadette (6-8)

Senior (9-10)

Ambassador (11-12)

Provide indirect service, support adults who work directly with girls

How would you like to participate in Girl Scouting?

Volunteering with girls

Troop/group leader/advisor

Overnight Trip / Camping Trip

Troop Treasurer

Parent Helper

Product Sales

Day Camp

Resident Camp

Other

If Choosing "other", please elaborate:

If choosing "other", or volunteering for a specific event or program please elaborate:

List any specialized skills/work or volunteer experience/talents/interests

Which languages other than English do you speak proficiently?

Background

For the protection of the girls, Girl Scouts of Colorado requires the following information from all volunteers. All information provided will be kept confidential. FAILURE to provide the information below or discrepancies between the information below and the results of the criminal background history obtained from the reporting agency may result in non-appointment.

Are there any pending criminal charges against you?

Yes

Are there any pending civil charges against you?

Yes

Do not include minor traffic violations or any convictions as a youthful offender.

Have you ever been charged with a misdemeanor or felony, including, but not limited to charges related to theft, embezzlement, domestic violence or other violence against persons, property crimes, driving while impaired, driving under the influence?

Yes

Do not include minor traffic violations or any convictions as a youthful offender.

Have you ever been convicted of a misdemeanor or felony, including, but not limited to charges related to theft, embezzlement, domestic violence or other violence against persons, property crimes, driving while impaired, driving under the influence?

Yes

Have you ever been charged with child neglect or abuse?

Yes

Have you ever been convicted of child neglect or abuse?

Yes

Is there a registered sex offender living anywhere on your premises?

Yes

Have you ever had your driver's license suspended?

Yes

Have you ever had your driver's license revoked?

Yes

Explain any "yes" responses and if applicable, please indicate offense, date, location (including town/state) and case number.

I will complete and submit (with the $12 background check fee or financial assistance request) the Background Check.

Yes

References

ReferencesPlease list three (3) non-relatives who do not live at your address, can speak to your qualifications to be a Girl Scout volunteer and have agreed to serve as a reference. If you have experience volunteering or working with children, include references from those organizations.

Ref. 1: Name

Email or Phone number to contact

Ref. 2: Name

Email or Phone number to contact

Ref. 3: Name

Email or Phone number to contact

Agree

I understand that I must become a registered adult member of Girl Scouts of the USA, complete training required for this volunteer position, be at least 18 years of age r and have NO OUTSTANDING DEBT WITH A GIRL SCOUT TROOP OR WITH ANY GIRL SCOUT COUNCIL. If the position requires, I have the ability to keep accurate records and account for all monies received by the troop. Additional information may be requested for other positions. I authorize contact of references and verification of information for my placement in a position. I understand that misrepresentation or omission of facts requested is cause for non-appointment as a volunteer. I further understand that this Volunteer Application does not constitute a contract and that Girl Scouts of Colorado retains absolute discretion in selecting and retaining its volunteers.“Every adult volunteer in Girl Scouting must be selected on the basis of qualifications for membership, ability to perform the job, and willingness and availability to participate in training for it. In selection of adults, there shall be no discrimination on the basis of race, color, ethnicity, sex, creed, national origin, or socioeconomic status. There shall be no discrimination against an otherwise qualified individual by reason of disability or on the basis of age.” (Girl Scouts Blue Book of Basic Documents 2009 (21)). Girl Scouts of Colorado Council does not discriminate on the basis of age, race, color, creed, religion, sex, disability, national origin, citizenship, marital status, sexual orientation, gender identity, gender expression, or any other status besides the foregoing that is protected by federal, state or local law (Girl Scouts of Colorado Equal Employment/Affirmative Action Policy (approved 7/2008)).

Signature

Where did you receive information about volunteering for Girl Scouts (please mark all that apply?)

Volunteer Match

Employer

Poster

Website

Community event

Media

School

Council staff

Other

Next Steps