Governance Interest Form
Thank you for your interest in Governance. Please complete this form and we look forward to speaking with you soon.
Name
*
First Name
Middle Name
Last Name
County of Residence
*
Please Select
Citrus
Hernando
Hillsborough
Marion
Pasco
Pinellas
Polk
Sumter
Gender
*
Race/Ethnicity
Organization
Position
Preferred Phone Number
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Explain your desire to serve the Girl Scout Mission.
*
What is your experience serving on Governance related committees and/or boards?
*
Which Governance opportunities interest you?
*
First Choice
Second Choice
Third Choice
Board Development Committee
Finance Committee
Fund Development Committee
Properties Committee
Membership Sustainability Committee
Board of Directors
Submit
Should be Empty: