Name:
Region (refer to map of regions PDF): Select One Region 1: South Region 2: West Region 3: East Region 4: North Service Unit:
Street address:
City: State: ZIP:
Home Phone: Cell Phone: Work Phone:
Email:
Years registered as an adult:
Years registered as a girl:
The information in this nomination form will be used for biographical information on the ballots, planning for training, development of regional meeting agenda and priorities, and to help inform the future work of the governance committee. Thank you!
Able to be objective, representing the best interests of the Girl Scout Movement, not just a particular geographic area or program level Definitely Somewhat Limited
Understand of the role of Governance in the organization Definitely Somewhat Limited
Able to participate as a member of a team Definitely Somewhat Limited
Able to speak in front of small and large groups Definitely Somewhat Limited
Willing to attend service unit, neighborhood, or other meetings Definitely Somewhat Limited
Why are you interested in being a regional delegate?
Please list your present/past positions in Girl Scouting (give approx. dates, if possible) Have you ever attended a council annual meeting, area or regional meeting? Yes No If yes, as a: Delegate Alternate Other
What special qualities or particular experiences, knowledge, and/or skills will you bring to the role of regional delegate? (e.g. representative for an school, religious or civic organization, board member, policy development, communications, etc.)
What positive changes for GSEM would you like to see over the next few years?
What ideas do you have for communicating within your region to towns, cities, and service units?
By clicking "Send", I certify that I have read the position description (PDF) for GSEM Regional Delegate. If elected, I am willing to serve as a delegate or alternate and I able to fulfill all the duties listed
