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Girl Scouts of Ouachita Council
Building Strong Minds, Strong Women, and a Strong Tomorrow.

 






Updated 05/11/05
Copyright 2005 Girl Scouts of Ouachita Council. All rights reserved.
The GIRL SCOUT name, mark and all associated trademarks and logotypes, including the Trefoil design, are owned by GSUSA.
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Girl Scouts of Ouachita Council Referral Form
for the Board of Directors or Nominating Committee Positions

If you prefer to fill out a paper form (MSWord or PDF) and mail please return to the Council Office to the attention of the Executive Director.  Otherwise you can submit your nomination using the form below.

Mrs./Ms./Miss/Mr./Other
*Last Name
*First Name
Middle Name
*Address
*City/State/Zip
*Home Phone
Cell Phone
*Employer
*Title
Business Address
City/State/Zip
*Business Phone
Business Fax

Submitted by:
*Last Name
*First Name
*Address
*City/State/Zip
*Home Phone
Cell Phone

I would like to nominate this candidate for Girl Scouts of Ouachita Council (choose from the three positions below):
Board of Directors/Foundation Board of Directors/Nominating Committee

All Information with an * is required before submission

The following is used to assist the nominating committee in fulfilling the requirements for a board of directors that represent diverse population groups. This will allow the board to reflect a variety of points of view and life experiences as well as

Race:
American Indian/Asian/Black/White

Those reported also of Hispanic Origin:
American Indian/Asian/Black/White

Age Range:
18-29/30-39/40-49/50-59/60 plus

Geographic Location
Urban/Surban/Rural
North/South/East/West

Marital Status
Single/Married/Divorced/Wiidow or Widowed/Significant Other/Dependent Children

Religious Preference
American Indian/Islamic/Jewish/Budhist/Catholic/Hindew/Protestant/Other