Camp CEO 2024 Volunteer Application

Thank you for expressing interest in being a Mentor for Camp CEO 2024!

Camp CEO will be on September 27-29 and will take place at Camp Butternut Springs in Valpairaiso, Indiana in the Fall of 2024!

To be considered for the role as a Mentor in Camp CEO, you must complete the application process. The last day to complete the application is August 5, 2024.

If you have any questions, please reach out to Jauzlyn Hardy jhardy@girlscoutsgcnwi.org and Glynnis Hokenson ghokenson@girlscoutsgcnwi.org.

We look forward to getting to know you soon!

General Information

First Name *

Last Name *

Preferred Name

Preferred Pronouns

Email *

Phone Number *

T-Shirt Size *

What is your favorite Girl Scout Cookie? *

Home Address *

City *

State *

Zip Code *

Name of Business/Organization *

Professional Title *

Your Favorite Headshot *

Please select the availability status that applies to you. *

Are you willing to complete a Background Check? *

We kindly request you to provide the following self-identifying information. We encourage the participation of individuals from various racial and cultural backgrounds, so your participation is appreciated. This information will be used for data purposes exclusively and will have no influence on the selection process. (Optional)

Tell Us more About Yourself

Which career area do you best fit in? *

What are your favorite hobbies/special interests? (Pick your top 2) *

Your Personal Mission Statement *

0/75 words

What does leadership mean to you? *

0/200 words

What advice would you give your teenage self? *

0/200 words

What do you wish to gain from Camp CEO? *

0/200 words

Which personality type do you identify with the most? *

Extrovert - draws energy from being around people, likes to attend social events

Introvert - draws energy from individual reflection, likes to spend time alone or with one or two people

Ambivert - can balance between being social and having self-reflection/alone time

How would your friends describe you? *

How would you describe yourself? *

How do you handle stress? *

0/50 words

What makes you unique? *

Please select the TWO outdoor activities that you would like to participate in. *

Archery

Rock Climbing

High Ropes Course

None

What is the best way for your Mentee(s) to reach you after Camp CEO? (Check all that apply) *

Email

Phone Number

Other Other

Please provide a link to your LinkedIn profile, bio on corporate website, or other online listing that provides additional information about you.

Have you participated in Camp CEO as a Mentor/Volunteer before? *

If you selected "Yes", please tell us in what year(s) you participated.

What are the names of your previous Mentees? (If applicable)

Health Information

Emergency Contact Name *

Emergency Contact Phone Number *

Emergency Contact Relationship *

Do you have any accommodation needs that we should be aware of? (i.e. large print materials, preferred seating)

Are there any major health conditions that we should know about in the event of an emergency? (i.e. asthma, seizures, diabetes, heart problems)? Please explain below.

Please list any allergies or dietary restrictions that we need to be aware of. (i.e. gluten, peanut butter)

Name of Physician *

Physician Phone Number *

Video and Photo Consent

Any photographs or films taken in which the registered participant appears may be used for promotion or as deemed appropriate by the Girl Scout council free of any claims on my part. *