Girl Scout Council of the Mid-South


	Adult Volunteer Interest Indicator

Adults are KEY to the success of Girl Scouting! Help us to help girls in our community by filling out this questionnaire.

Fields marked with an asterisk * are required.

First Name:*

Last Name:*

Address:*

City:*

State:*

Zip:*

Home Phone:*

Work Phone:

Cell Phone:

E-mail Address:

Occupation:

Employer:

How did you hear about us?

What type of volunteer position are you interested in? (please check all that apply)*

I prefer to spend my time with girls in troops or groups.

I'd like to spend my time with adults.

Site preference:

school place of worship community center
other

I can give:

hours per week month occasionally

I am available:

days evenings weekends after school
flexible

I am interested in volunteering:

in my community - Specify Community
anywhere within council's jurisdiction

Volunteer Experience:*

Name of organization(s) and
position(s) held:

Please indicate special interests:

I have the following additional skills, abilities to offer: (check all that apply)

Architecture
Arts
Audio visual
Auto maintenance
Boating - Type:
Bookkeeping and Accounting
Business administration / career planning
Camping
Child care
Citizenship
Clerical (typing, computer, filing, answering phone)
Community advocate
Computers
Cooking / nutrition
Corporate planning
Crafts / folk arts
Dance
Energy conservation
Event planning
Environmental issues
First aid / health and safety
Global issues
Health and fitness

Hiking
Horseback riding
Human relations skills
Issues that affect girls and women
Leadership / organizational
Literacy - helping others to read
Mathematics
Mediation
Music
Outdoor camping or naturalist experience
Painting
Photography / videography
Property management expertise
Public relations/marketing
Public speaking
Sales
Sciences
Sports
Story telling
Techno savvy
Theater
Travel planning
Water safety / Lifeguarding

Please list other skills below:

You may submit form electronically by clicking submit or print and deliver to the
Girl Scout Council of the Mid-South
Mail: PO Box 240246, Memphis, TN 38124-0246
Deliver: 2715 Kirby Parkway, Suite 1
Fax: (901) 797-2183