Facilitator application

GSCI Facilitator Application
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Best Time to Call
Date of birth

MonthDayYear
Service Unit
Is your Girl Scout membership and background check current?
What areas interest you?
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 is your county of residence?
Do you have experience as a facilitator, teacher or trainer?
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 from 1-5, where 1 is "disagree" and 5 is "strongly agree", rate your expertise 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.

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1 is Disagree, 5 is Strongly Agree
I think quickly and logically with the ability to analyze comments and questions, understand how they relate to the topic, and develop appropriate responses.

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1 is Disagree, 5 is Strongly Agree
I practice active listening skills by engaging a participant, listening attentively, and asking probing questions.

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1 is Disagree, 5 is Strongly Agree
I convey warmth to others by using smiles, praises, and gestures in one-on-one and group interactions.

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1 is Disagree, 5 is Strongly Agree
I treat all individuals in an equal and fair manner, demonstrating pluralism and inclusion.

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1 is Disagree, 5 is Strongly Agree
I communicate clearly and expressively by making specific, concise points, using appropriate levels of energy to build excitement and enthusiasm.

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1 is Disagree, 5 is Strongly Agree
I demonstrate self-confidence, maturity and sound judgement when working with others, being the person others look to for direction and counsel.

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1 is Disagree, 5 is Strongly Agree
I assume responsibility for my volunteer position, including managing my personal time and volunteer time and a commitment to providing dependable service.

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1 is Disagree, 5 is Strongly Agree
I have a positive attitude towards change, and am willing to keep up with the latest materials and programs.

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1 is Disagree, 5 is Strongly Agree
I have knowledge and ability to explain Girl Scout policies and procedures.

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1 is Disagree, 5 is Strongly Agree
I certify that all the information 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 permission to Girl Scouts of Central Indiana to conduct a criminal background and/or credit check.
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GSCI Facilitator Application

Rate yourself!