Volunteer Application Form

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Girl Scouts Diamonds of Arkansas, Oklahoma, and Texas
Return to: Diamonds Council Regional MMS
Girl Scouts-Diamonds
Girl Scouts-Diamonds
2080 E. Joyce Blvd. Fayetteville, AR 72703
615 West 29th St. North Little Rock, AR 72114
Girl Scouts-Diamonds
Girl Scouts-Diamonds
5705 Gordon Lane, Fort Smith, AR 72903
3300 Taloha Road, Pine Bluff, AR 71603
Girl Scouts-Diamonds
Girl Scouts-Diamonds
4803 East Johnson Ave. Jonesboro, AR 72401
1811 Arkansas Blvd. Texarkana, AR 71854
Name: ______________________________ Email: _______________________________________
Street: ______________________________________________________________
Town/State/Zip: ________________________________________________
Telephone # (
) ______________ Date of Birth: ___________________
Cell # (
) _______________________________________
Mailing Address: _______________________________________________ (if different from above)
Have you ever been investigated for, charged with or convicted of a felony or misdemeanor including
but not limited to DWI, DUI, child abuse or neglect, molestation or the misappropriation of funds not
including minor traffic violations or any convictions as a youthful offender as set out by the laws of the State
of Arkansas or any state in the United States of America?
___ YES ___ NO
If yes, please explain the offense, place, and date and final settlement of any
convictions____________________________________________________________________________
Are you a Registered Sex Offender, or do you live with a Registered Sex Offender?
___Yes ___ NO
If you are a new volunteer, what type of service would interests you? (Check all that apply)
Preferred Program Level
Troop Position
Troop Position
__ Daisy K – 1
___ Troop Leader
___Troop Magazine Manager
__ Brownie (Gr 2-3)
___ Asst. Leader
___ Day Camp Helper
__ Junior (Gr 4-5)
___ Troop Cookie Manager
___ Song or Game Leader
__ Cadette (Gr 6-8)
___ Troop Camping Helper
___ Troop Support Committee
__ Senior (Gr 9-10
___ Troop Activity Consultant
Other _____________________
__ Ambassador (Gr 11-12)
Non-troop volunteer
Non-troop volunteer
Availability
___ Event/Activity Volunteer
__ Office/clerical Work
___ Year Long
___ Work with other adults
__ Cookie Sales Program
___ Monthly
___ Training Adults
__ Public Speaking
___ Quarterly
___ Outdoor Program Instructor
__ Transportation
___ One-time Event
___ Youth Development
Other _________________

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