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Emerging Leaders Interest Form

Emerging Leaders provides access to unique opportunities only Girl Scouts can deliver, connecting you to a dynamic network of women leaders and a peer group who share similar special interests. Through Emerging Leaders, you can pick your passion by creating a pathway for participation based on your areas of interest. Emerging Leaders programming includes:
- Small group mentoring opportunities
- Career Exploration workshops
- Social Impact skill development
- Educational pathways for Life Beyond High School
Sign up below to start your journey!
Girl Information
Girl Name:*
First Last
Girl Address:*
Street Address Address Line 2 City State ZIP Code
Girl Email:*
Enter Email Confirm Email
Home or Cell Phone:*
Grade:*
Age:*
Are you a current Girl Scout?*
- Yes
- No
Which of the following apply:*
- I am a member of a troop
- I am an individually registered girl
Girl Scout Program Level:*
Troop Number (Five Digits):*
Parent/Guardian Information
Parent/Guardian Name:*
First Last
Parent/Guardian Email:*
Enter Email Confirm Email
Parent/Guardian Home or Cell Phone:*
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Participation
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Are you interested in participating in the new Emerging Leaders Mentorship Program in October 2022? Each session will take place once a week from 6-7 p.m. over the course of 3 weeks in October and into the first week of November. There will be one Mentor per 4-5 Girl Scouts, or two Mentors per 8-10 Girl Scouts. The cost for participation is $5 and a registration link will be emailed to you once you are matched with a mentor.*
- Yes
- No
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Please select your 1st choice of mentor topic.*
- Engineering, Architecture, and Construction
- Entertainment
- Game Development, App Development & Technology
- General - Women in Business
- Health & Beauty
- Mental Health & Wellness: Stress, Anxiety & Healthy Relationships
- Public Policy & Civic Engagement
- Science, Medical & Health
- Visual Arts
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Please select your 2nd choice of mentor topic.*
- Engineering, Architecture, and Construction
- Entertainment
- Game Development, App Development & Technology
- General - Women in Business
- Health & Beauty
- Mental Health & Wellness: Stress, Anxiety & Healthy Relationships
- Public Policy & Civic Engagement
- Science, Medical & Health
- Visual Arts
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Please select which session you’re available. If you’re available for both sessions, select both.*
- Select All
- Group A: October 11, 18, 25 and November 1
- Group B: October 13, 20, 27 and November 3
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Interested in different topics? Please add your suggestions below.
Terms of Submission*
Please note, by completing this form you are opting into the Emerging Leaders network. You are NOT registered for the Mentorship and Career Exploration program.

Information on registering for the Mentorship and Career Exploration program will be
emailed to you in August.
- I understand the terms of submission.
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