Volunteer Application

Section 1 Personal Information

Fields marked with * are required entries.

Please Select:*

New Application
Update for Current Volunteer

Name*

FirstLast

Mailing Address*

Street AddressAddress Line 2CityState / Province / RegionZIP / Postal CodeCountry

Phone*

Email*

Enter EmailConfirm Email

Maiden/Former Name*

Date of Birth*

What is the best time to contact you?

Morning
Afternoon
Evening

Have you volunteered at another council?*

Yes
No

Council Name:

Section 2

How did you hear about this volunteer opportunity?

Other

Why are you applying to be a volunteer?

Other

Section 3 Volunteer Preference

Fields marked with * are required entries

Duration of volunteer service*

Ongoing
Short-Term
One-Time
Seasonal

Best Day and time

Do you own or have access to reliable transportation?*

Yes
No

What distance are you willing to travel to volunteer?*

None
Within 10 Miles
Within 25 Miles
More Than 25 Miles

Drivers License #*

Vehicle Insurance Carrier*

Insurance Policy #*

Which grade level is preferred?

Which program opportunities are you interested in (choose one or more)?*

If you prefer a specific community, school or troop #, please specify:

Indirect (Working with adults in a supporting role)

Other:

Section 4 References

Fields marked with * are required entries

Reference Name*

Address*

Street AddressCityZIP Code

Telephone*

Email

Enter EmailConfirm Email

Relationship to you*

Section 5 Special Skills

Languages other than English:

Fluency:

Limited
Good
Expert

Do you have any current specialized certifications?

(please list)

Do you have any other special skills, talents and abilities?

(Check all that apply)

Other

Section 6 Legal

GSKH does not appoint individuals as volunteers if they are a convicted felon, a registered sex offender, or have a registered sex offender living in their household.

Confidential Information
Please answer the following questions.
(Fields marked with * are required entries)

1. Have you ever been convicted of a crime other than a minor traffic offense?*

Yes
No

2. Is a member of your household a registered sex offender?*

Yes
No

3. Are you currently or have you ever been under treatment for alcoholism, drug addiction, or drug abuse?*

Yes
No

4. Have there ever been allegations, complaints or reports regarding your involvement in child abuse or neglect?*

(regardless of whether the incident was confirmed or denied)

Yes
No

If you answered yes to questions 1, 3, or 4, please provide a brief explanation below for each “yes” answer.

Section 7 Authorization for Criminal Background Search

I will go through the online portal to enter my personal information for the criminal background search. Upon successful submission of this application, the page will continue to the instructions for the Criminal Background Check.

I prefer to have an authorization form emailed to the address listed above.

*

Application will not be processed until the authorization for the Criminal Background Search is completed and received online or through email or mail. I understand that my volunteer assignment will not go into effect until the Application and Criminal Background Checks are complete and I have been notified of approval.

By typing my name below I indicate that I have read, understand, and consent to the Criminal Background Search.
TYPE YOUR FULL NAME AS YOUR SIGNATURE

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Girl Scouts of Kansas Heartland

Online Volunteer Application

Section 1 Personal Information

Section 2

Section 3 Volunteer Preference

Section 4 References

Section 5 Special Skills

Section 6 Legal

Section 7 Authorization for Criminal Background Search

Teens

Traditions & Trailblazing

Pathways