*Have you ever been convicted of a crime (e.g., felony or misdemeanor including DWI, DUI, etc., but not including minor traffic violations or any convictions as a youthful offender)? A conviction will not necessarily bar your acceptance as a volunteer.
This is an application for a volunteer position in Girl Scouting for which there is no monetary compensation.
In the selection of volunteers, there shall be no discrimination against an otherwise qualified individual on the basis of race, color, ethnicity, sex, religion, creed, national origin, socioeconomic status, age, disability, marital status, veteran status, or any other basis prohibited by federal, state, or local law.
I hereby authorize you to check all my educational, personal, and employment references; I further authorize these references to release to you information that they have about me.
I authorize Girl Scouts of Ohio’s Heartland, to conduct a criminal records check at their discretion and agree that, if requested, I will fully cooperate in providing all information and signing all documents necessary to conduct such a check.
Appointment to certain volunteer positions is subject to a satisfactory criminal background check.
I understand that any misrepresentation, omission, or falsification of any fact from this application or during any interview will be cause for rejection of this application or dismissal from volunteer services. I also understand that acceptance for volunteer services are subject to verification of references.
I certify that my answers to the preceding questions are true and complete and that I have not knowingly withheld any information which might, if disclosed, have a negative effect on my application.
I hereby authorize the Girl Scouts to perform all reasonable and necessary background investigations regarding my application to be an active volunteer for the Girl Scouts. I also authorize the Girl Scouts to inform necessary persons of any limitations in my ability to volunteer identified by such background investigation, including but not limited to applicable adult leaders. I hereby release and hold harmless the Girl Scouts and any volunteers regarding any conduct or disclosure resulting from any investigation which I have authorized herein.
By typing my name on this form, I am entering my “electronic signature” (as that term is defined in the Uniform Electronic Transactions Act, RC 1306.01, et seq) and certifying that I have read, fully understand and accept all terms of this registration
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