GSCI Facilitator Application
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Email
Phone Number
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Date of birth
-
Month
-
Day
Year
Date Picker Icon
Service Unit
Please Select
153 Parke/Vermillion County
162 North/South Vigo County
163 Central Vigo County
181 Clay County
183 Putnam County
202 Wayne/Union County
204 Franklin County
205 Fayette County
206 Rush County
316 Grant County
337 Madison County
354 Randolph County
365 Henry County
371 Blackford Coutny
372 Delaware County
382 Jay County
401 Carroll County
407 Howard/Tipton County
520 White County
540 Tippecanoe County
570 Clinton County
580 Montgomery County
590 Benton/Fountain/Warren County
602 Sterling (Boone County)
603 Pike Township
605 Zionsville
607 Danwood (Danville)
608 Westside Indy (Wayne Township)
609 Hunter (Brownsburg)
610 Avon
611 Hamilton Southeastern
612 Morgan County (Martinsville/WaMoNa)
614 Decatur Township
617 Warren Township
625 Irvington/Ft Square
627 SouthEast Indy
628 Shelby County
629 Johnson County South
630 Fishers
635 Midtown
641 Ft Ben (Lawrence Twp)
642 Washington Township
650 East/Central Marion County
651 Manuka (Noblesville Area)
653 JoSheWe (Westfield/Sheridan)
660 Wagon Trail (Plainfield)
663 Carmel East
665 Carmel West
670 Greenwood
671 Hancock County
672 Perry Township
701 Bartholomew County
702 Decatur County
707 Brown County
718 Monroe/Owen County
771 Sullivan County
772 Greene County
774 Switzerland County
775 Ripley County
787 Lawrence County
Unknown
Is your Girl Scout membership and background check current?
Yes
No
Uncertain
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?
Yes
No
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.
Disagree
1
2
3
4
Strongly Agree
5
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.
Disagree
1
2
3
4
Strongly Agree
5
1 is Disagree, 5 is Strongly Agree
I practice active listening skills by engaging a participant, listening attentively, and asking probing questions.
Disagree
1
2
3
4
Strongly Agree
5
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.
Disagree
1
2
3
4
Strongly Agree
5
1 is Disagree, 5 is Strongly Agree
I treat all individuals in an equal and fair manner, demonstrating pluralism and inclusion.
Disagree
1
2
3
4
Strongly Agree
5
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.
Disagree
1
2
3
4
Strongly Agree
5
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.
Disagree
1
2
3
4
Strongly Agree
5
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.
Disagree
1
2
3
4
Strongly Agree
5
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.
Disagree
1
2
3
4
Strongly Agree
5
1 is Disagree, 5 is Strongly Agree
I have knowledge and ability to explain Girl Scout policies and procedures.
Disagree
1
2
3
4
Strongly Agree
5
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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