Date: 9/20/2013
Girl Scouts of Virginia Skyline Council, Inc.
Volunteer Referral Profile Form
Self Referral
OR Referred By Karen Ford
I have not spoken to this person about serving.
I have spoken to this person about serving on:
The Board,
The Board Development Committee,
Name: (Mr.
Address:
, Ms.
, Mrs.
Other Committee(s)
(specify)
) Dr. Dawn Watkins
, Lexington, VA
Street, City, State Zip
E-mail address(es): dawn@beingplaid.com;
@
Phone #s: Mobile: (540)461-0746, Work: (855)BEING-PLAID, x 107, Home: (
Current Girl Scout
Former Girl Scout
Current Girl Scout Volunteer
Former Girl Scout Volunteer
)
-
No current Girl Scout affiliation
Parent of Girl Scout
Employment:
Retired
Self-employed
Private Sector
Public Sector
Volunteer Organization
Student
Educational Institution
Other:
Home Worker
(specify)
Current Employer:
Position: Vice President, From 9/11 to present
Company/Organization: Plaid
Address: 9525 Knollcrest Blvd, Alpharetta, GA 30022-8455
Street, City, State Zip
Previous Employer:
Position: Vice President, From 8/01 to 5/11
Company/Organization: Washington and Lee University
Address: Washington Street, Lexington, VA 24450
Street, City, State Zip
Education:
High school,
Community College/Trade School,
4-Yr. Degree: B.A., English (Specify degree and
major)
Advanced Degree(s): M.A.Ed., Counseling and Student Personnel Services, Ph.D., Higher Education
Administration/Organizational Management (specify degree(s) and major(s))
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Your Skills and Expertise:
Please indicate the 3 areas (as 1, 2, 3) where the person being referred has the highest skill or expertise to
share with the Girl Scouts with 1 being the area of highest skill/expertise. (You can mark other skills with an
‘x’.)
Finance and Accounting
Construction / Building Repair & Maintenance
Business Management
Real Estate
Human Resource Management
Engineering
Legal Services
3 Education - Children
2 Insurance/Risk Management
3 Education - Adults
Public Relations / Communications
Lobbying / Advocacy / Legislative Relations
Marketing
1 Strategic Planning
Fund Development
Religious Activities
Technology (Computer Networks / Systems)
Medical
Parliamentary Procedure
Other
Prior Board / Volunteer Experience:
No prior Board experience
Has served on boards for:
private business(es)
public organization(s)
non-profit organization(s)
Please list: Currently serve on distinguished alumni board at Virginia Tech and as secretary to a board at a local
pre-school, Yellow Brick Road Early Learning Center.
Community Service / Volunteer Work / Girl Scout Experience: I have been affiliated with Troop 161
(Lexington) in the Skyline Council
-The following information is voluntary but will help us maintain diversity in the Girl Scout organization.
Race:
Age:
American Indian/Alaskan Native
Asian or Pacific Islander
Hispanic
Caucasian
Mixed Racial Origin
16-18
30-39
40-49
19-29
Geographic Residence Location:
Religious Preference:
Black
Urban (City)
Suburban
50-59
Other:
60 or over
Rural
Protestant
Catholic
Jewish
Islamic
Buddhist
American Indian Spiritual Tradition
No Preference/Other:
Hindu
Please return completed form to the Board Development Committee. Thank you!
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