Girl Board Member Application & Parent/Guardian Statement

Girl Scouts of Kentuckiana is committed to providing access and reasonable accommodations in its programs, activities, volunteer service, and employment. If you require a disability-related accommodation or language assistance when completing the Girl Board application, please contact the Board Liaison (Bailey Roman broman@gskentuckiana.org) for support. We are dedicated to ensuring all individuals have an equitable opportunity to apply and participate.

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Cell Phone Number*

(000) 000-0000Format: (000) 000-0000.

Email*

example@example.com

Troop Number & Level*

Number of years in Girl Scouting*

Name of High School*

Current School Grade*

Applicant Participation, Service, and Leadership in Girl Scouts and Community Activities

Fill out questions A and B below:

A. Describe the ways in which you have been involved in Girl Scouts, including any service and leadership roles:*

B. Describe any activities and obligations, including service and leadership roles, that you have outside of Girl Scouts (e.g., school, church, community, extracurricular)*

Applicant Questions

Fill out questions 1–4. Question 5 is optional.

1. Why are you still a Girl Scout? How has Girl Scouting made a difference in your life?*

2. Why do you wish to serve as a girl member of the Board of Directors?*

3. What do you see as your role on the Board of Directors? *

4. If chosen, how will you balance the Board of Directors expectations and your other school and community engagement? *

5. Optional: Anything else you would like to share with the Board Development Committee to support your application:

REFERENCE LETTER

A reference letter is required to be provided by someone who knows you well and is familiar with your Girl Scout engagement. Please do not ask a relative to write a reference letter. Let your reference know that their letter must be received no later than the Girl Board Member Application deadline of April 24, 2026.

The reference letter needs to be submitted on a separate JotForm using the link below.

It is your responsibility to follow up on the reference and confirm that the letter has been sent and received on time.

REFERENCE LETTER SUBMISSION LINK

Please share the link below with your reference for them to use to submit your Letter of Reference to Girl Scouts of Kentuckiana. Remember, all materials are due by 11:59 pm EDT, April 24, 2026.

https://gskentuckiana.jotform.com/260485235674160

Complete the Reference Contact Information section below.

Name of Reference:*

First NameLast Name

Reference Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Reference Phone Number*

(000) 000-0000Format: (000) 000-0000.

Reference Email*

example@example.com

Applicant Statement

I have read the position description of girl member of the Board of Directors for Girl Scouts of Kentuckiana, and the information above. I understand the timeline and expectations, including the need to miss school to attend these meetings. If selected, I will fulfill those expectations to the best of my ability.

Signature of Applicant:*

Please sign here

Date:*

Parent/Guardian's Name*

First NameLast Name

Girl Board Member Application

Girl Board Member Application - Parent/Guardian Statement