If hired for a position with Girl Scouts of Wisconsin - Badgerland a background check will be done.   Please provide the following information.

(A conviction record will not necessarily be cause for diqualification)

Explain driver's license being revoked or suspended:

Enclosed in your application packet are three (3) reference forms.  Please print your name at the top of each form BEFORE distributing them.  Each form should be filled out and returned directly to Girl Scouts of Black Hawk Council, Inc. by the persons who know of your skills and abilities.  We recommend former employers, teachers, professors, ministers, counselors, Girl Scout leaders or other persons who can give an honest accounting of the type of person you are.  References by personal friends, or relatives WILL NOT be considered.   Please list the name, relationship and phone number of the three persons who will be providing your references.

It is important that your references be returned by those individuals filling them out as soon as possible.  YOUR APPLICATION WILL NOT BE CONSIDERED UNTIL ALL THREE REFERENCES ARE RECEIVED.

We realize that structured applications often do not allow the applicant to express certain skills, talents, training, or other information about themselves which might be of interest to the employer.  We encourage you to list on a separate sheet any additional information about yourself that you feel is important, and attach to this form.  If you have a current resume, you may enclose it with your application.

WAIVER AND RELEASE
 I certify that all information provided in this employment application is true and complete.  I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date.

I understand that if I am extended an offer of employment it may be conditional upon my successfully passing a complete physical examination and current health history required by the State of Wisconsin. 

I UNDERSTAND THAT THIS APPLICATION OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE A CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME.  IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME, WITH OR WITHOUT CAUSE AND WITH OR WITHOUT NOTICE.

I am aware that I must become a member of the Girl Scouts of the U.S.A. I have read, understand, and by my signature consent to these statements.