Girl Scouts of Connecticut
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APPLICATION FOR VOLUNTEER SERVICE WITH GIRL SCOUTS OF CONNECTICUT

Girl Scouting maintains that the strength of the organization rests in the voluntary leadership of its adult members. In appointing volunteers to Girl Scout volunteer positions, it is important that the qualifications of the position match the skills, interests, and time availability of the volunteers. Information provided will be maintained in a confidential manner.
To ensure confidentiality, the information in this application can not be saved.
Please complete the following information:  (note, fields marked * are required)

Basic Information
M.I.
First Name*
Last Name*
Daughter's/Ward's Name(s) (if applicable)
Address*
City*
State*
Zip*
If not at this address for more than two years, please give prior address(es).
E-mail address*
Town Where Interested in Volunteering* Troop/Group No.
Home/Cell Phone*
Work/Alternate Phone
Please indicate other names and nicknames that you have used that may be necessary for us to verify the information on this application.
List other Girl Scout Councils with which you have been involved.
Volunteer Position Sought
Employment Information
Please provide accurate and complete information for your current or last employment (including temporary, part-time, self-employment, or unemployment).
Employer's Name
Start Date
End Date
Address
Position(s
Reason for Leaving
Supervisor's Name
Phone Number with Area Code:
Volunteer Experience
(List previous Girl Scout or other youth service first.) Please provide accurate and complete information for all volunteer experience for the last ten years.

Organization 1

Organization's Name
Start Date
End Date
Address
Positions
Responsibilities
Supervisor's Name
Email Address
Phone Number

Organization 2

Organization's Name
Start Date
End Date
Address
Positions
Responsibilities
Supervisor's Name
Email Address
Phone Number

Organization 3

Organization's Name
Start Date
End Date
Address
Positions
Responsibilities
Supervisor's Name
Email Address
Phone Number
Additional Information
Hobbies, skills, training, and educational background - Please describe.
Transporting Girls

When transporting girls to planned Girl Scout field trips and other activities that are outside the normal meeting day, time, and place, every driver must be an approved adult volunteer and have a good driving record, a valid operator's license appropriate to the vehicle, and a registered/insured vehicle.

Girl Scouts of Connecticut requires every driver to complete the Troop/Group Driver Annual Form prior to transporting Girl Scouts. This form must be completed annually and requires an original signature. (Volunteer Essentials, Responsibilities of the Volunteer: Girl Scout Safety Guidelines, Travel Safely)

I will be volunteering as a Troop/Group driver only

This is an application for a volunteer position with Girl Scouts of Connecticut for which there is no monetary compensation.

In the selection of volunteers, Girl Scouts of Connecticut does not discriminate against any person on the basis of race, color, religion, age, sex, sexual orientation, marital or civil union status, national origin or ancestry, political affiliation, socio-economic factors, genetic information, learning disability, physical or mental disability, military status, or any other protected class status.

I understand that it is my responsibility to provide two (2) personal references, none of which are related to me nor reside with me, that will affirm my ability to work in a leadership role within Girl Scouting. Should the need arise for additional information I hereby authorize you to contact my references.

Note: When you click "Continue" the information on this form will be submitted to GSOFCT and you will be taken to a page where you can input your reference contact information.

I further authorize these references to release to you any and all information that they have about me, and I release all parties involved from any liability arising out of the release of that information.

I understand that criminal background searches/checks are required by Girl Scouts of Connecticut, and I understand that these searches/checks may also be conducted on other individuals in my household.

I acknowledge that I have received a copy of the Background Search Policy and Procedures for Employees and Volunteers.

I understand, for my application to be considered, that I must complete the Authorization and Consent for Release of Information for Background Search form. This can be done by utilizing the secure online Background Search process, or by mailing the completed form directly to GSOFCT's Human Resource Department.

I understand that if appointed to a volunteer position, I will be required to comply with Girl Scouts of the USA and Girl Scouts of Connecticut policies and standards will enroll and maintain current membership with the Girl Scouts of the USA; and will fulfill my responsibilities to the best of my ability.

I understand that any misrepresentation, omission, or falsification of any fact from this application or during any interview will be cause for rejection of this application or dismissal from volunteer services. I also understand that acceptance for volunteer service is subject to receipt of reference forms or successful completion of the Volunteer Application Process which includes Background Screening.




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