Facilitator application

Facilitator application

Name
First
Middle
Last
Address
Street Address
Apt./Ste.
City
State
Postal Code
Best phone number
Area Code
Phone Number
Alternative phone number
Area Code
Phone Number
Best time to call
Birthdate (month/day, not year)
Email address
Service unit
Have you completed a volunteer application and background check?
What areas interest you? (check all you would like to present)
Girl Scouts of Central Indiana serves 45 counties across the state, and we often ask facilitators to drive within reasonable distances. Please check any counties to which you would be willing to travel.
What county do you reside in?
What type of facililtation interests you? (Check all that apply)
Do you have any experience as a facilitator already?
If yes, please tell us about it.
What skills and strengths do you hope to offer as a facilitator?
Special care or concerns (including food allergies and ADA):

Rate yourself!

On a scale of 1-10, where 1 is "not at all" and 10 is "I can confidently teach others how to do this", rate your skills in each of these areas:
I enjoy working with adults and have a genuine desire to help people feel good about themselves and achieve their desired results.
I think quickly and logically with the ability to analyze comments and questions, understand how they relate to the topic, and develop appropriate responses.
I communicate clearly and expressively by making specific, concise points, using appropriate levels of energy to build excitement and enthusiasm.
I practice active listening skills by engaging a participant, listening attentively, and asking probing questions.
I convey warmth to others by using smiles, praises, and gestures in one-on-one and group interactions.
I treat all individuals in an equal and fair manner, demonstrating pluralism and inclusion.
I demonstrate self-confidence, maturity and sound judgement when working with other, being the person other look to for direction and counsel.
I assume responsibility for my volunteer position, including managing my personal time and volunteer time, and a commitment to providing dependable service.
I have a positive attitude towards change, and am willing to keep up with the latest materials and programs.
I have the knowledge and ability to explain Girl Scout policies and procedures.
Is there anything else you would like to share with us?

References

List three (3) people not related to you who can tell us about your facilitation skills and how you work with adults. If you have previous experience as an volunteer, in Girl Scouts or other organization(s), please include them. Ask each person to fill out a reference form which is located at girlscoutsindiana.org/reference or in the facilitators sections of the website. All references are confidential.
Reference 1
First
Last
Mailing address
Street Address
Apt./Ste.
City
State
Postal Code
Email address
Phone
Area Code
Phone Number
Reference 2
First
Last
Mailing address
Street Address
Apt./Ste.
City
State
Postal Code
Email address
Phone
Area Code
Phone Number
Reference 3
First
Last
Mailing address
Street Address
Apt./Ste.
City
State
Postal Code
Email address
Phone
Area Code
Phone Number

Signature

I certify that all information provided on this application is true and complete. I understand that falsification and/or significant omissions may be considered justification for non-acceptance or dismissal if discovered at a later date. Girl Scouts of Central Indiana has my permission to contact my references regarding my qualifications and abilities. I give my permission to Girl Scouts of Central Indiana to conduct a Criminal Background and/or Credit Check.
Signature
Date
MM
DD
YYYY
Checking this box serves as my electronic signature.