Girl Scouts, Tarheel Triad Council, Inc. GIRL APPLICATION for PROGRAM AIDE TRAINING and LEADER IN TRAINING
In order to register for this training, girls need to do the following: 1. 2. Please complete this application neatly in black or blue ink. Give the completed application and reference form to your Troop Leader or other Girl Scout Adult who will be completing the reference form. 3. 4. The Troop Leader or other Girl Scout Adult completes the reference form. Please mail the application, reference form, and a check for $7.00 made out to GSTTC to the council office at 8818 W. Market Street, Colfax, NC 27235, Attention: Andrea Reavis.
Training applying for (check one): Q Program Aide Q Leader In Training Choice of dates: 1st Name of Applicant: Street Address: City/Town: Phone #: Birth Date: Troop/Group #: Leader’s Name: School Attending: Age: Email: # of years in Girl Scouting: State: Apt. #: Zip: Grade: 2nd 3rd
1.
Why do you want to take the Program Aide or Leader In Training Workshop?
2.
Experience working with children in Girl Scouting: Where did you work?
Position: Briefly describe your responsibilities:
When? How much time did you spend in this position? _ 1. _
3.
Experience working with children outside of Girl Scouting: Where did you work?
Position: Briefly describe your responsibilities:
When? How much time did you spend in this position?
What did you enjoy most about working with young children?
4.
Camping Experience:
In Girl Scouting: Where did you camp? What kind of camp was it (day, resident, outreach, etc.)? Briefly describe your responsibilities/skills:
When? How much time did you spend camping?
Outside Girl Scouting: Where did you camp? What kind of camp was it (YWCA, 4-H, etc.)? Briefly describe your responsibilities/skills:
When? How much time did you spend camping?
What did you enjoy most about camping?
2.
5.
Skills/Experiences/Interests:
Check those that you can share or teach others: Animals Architecture Astronomy Basketry Calligraphy Campcraft Skills Childcare/Babysitting Cheerleading Computers Cooking Dance Dramatics Drawing & Painting Ecology & Conservation Emergency Preparedness Fashion/Fitness/Make-Up Games Horses International Cultures Leather Mechanics Metalworks Music Photography Plants, Flowers, Trees Rocks & Minerals Science Sculpture Sewing/Needlework Singing Solar Energy Sports Swimming Weather Weaving Other:
6.
Do you speak a language other than English? Q Yes Q No
If yes, what language(s)?
7.
Do you know sign language? Q Yes Q No
8.
Have you been a Patrol Leader/Troop Officer? Q Yes
Q No
9.
School/Community/Church or Synagogue Leadership:
10.
Certifications: (list expiration dates)
Red Cross First Aid: CPR: Water Safety & Rescue: Advanced Life Saver: 3.
Water Safety Instructor: Basic Canoeing: American Camping Association: Childcare/Babysitting: Other:
11.
Placement Information:
Age level troop you prefer to work with: Q Daisy Q Brownie Q Junior
Age level unit you prefer to work with at camp: Q Daisy Q Brownie Q Junior
12.
Troop times other than at summer camp that you are available to work with younger troops: Q Tuesday Q Tuesday Q PM Q PM Q Wednesday Q Thursday Q Wednesday Q Thursday Q Friday Q Friday
After school: Q Monday Evening: Saturday: Sunday: Q Monday Q AM Q AM
I AM WILLING TO MAKE THE TIME TO PARTICIPATE FULLY IN THIS TRAINING AND WORK ASSIGNED.
Signature of Girl Scout
Date
4.
REFERENCE FORM FOR PROGRAM AIDE TRAINING
To be completed by applicant’s Troop Leader or other Girl Scout Adult. Name of Applicant: How long have you known the Applicant? In what capacity? Troop #:
Check one rating in each category to assess the following qualities of the applicant. Check “NA” if you do not know.
(1) (2) Fair (3) Average (4) Above Average Is dependable and responsible Relates well to new people Is able to communicate and share ideas, feelings Accepts differences in people Works well with younger girls Relates well to adults Is adaptable and flexible Shows humor and spontaneity Takes part in decision-making Is able to direct the work of others Is able to camp and work out-of-doors Has problem-solving ability (5) Superior (NA) Not Applicable
Qualities
Poor
Please describe the applicant’s strengths/skills and areas of weakness as they relate to a position of leadership:
Name (print): Position: Street Address: City/Town: Phone #: ( ) Email:
Signature: Date: Apt. #: State: Zip:
C:\Girl Program\Reference Form For Program Aide {5-05} NLW
5.