National Council Delegate Application

Deadline September 30, 2013


Personal Information:

First and Last Name (*)

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Service Unit (*)

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Address (*)

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City, State, Zip (*)

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Phone (*)

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Email (*)

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Please complete this section for statistical purposes:

Race/Ethnicity

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Please specify other Race/Ethnicity

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I am Hispanic or Latino/a

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Are you a U.S. Citizen? (required in GSUSA Congressional Charter) (*)

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Volunteer Experience (List volunteer experience including position, organization, and dates)

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While the Committee will consider a number of factors in making this ultimate selection, the Committee will also specifically seek candidates that model one or more of the characteristics and skills outlined below, with no one or combination of characteristics and skills being weighted more than others. Please self-assess your experience in each area (check on box per row).

Strategic Thinking

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Communication

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Policy Influence/Policy Making

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Knowledge of Girl Scouting

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Decision Making

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Adaptability

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Team Building

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I agree to carry out the responsibilities of a Delegate as described and to represent the Girl Scouts of Central Texas as an informed delegate.

Signature (*)

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Date (*)

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