GSSEM Employment Application

Note: Applicants for transfer or reemployment must also complete Supplement to Application for Employment in Girl Scouting
Current Address
Your prior conviction does not bar you from employment, but may be considered in relation to job requirements.
School Name and Location
Check Last Year Completed
Employment History
Present or Last Employer
Previous Employer

Applicants without recent employment experience must list persons other than relatives who know of your qualifications and/or background experience.

Reference Person #1


I affirm that the facts set forth in my Application for Employment in Girl Scouting are true and complete to the best of my knowledge.  I understand that false statements in this application may result in a refusal to hire, revocation of an offer of employment, or termination of employment once falsity of a statement becomes known.  I further understand that this does not alter the at-will employment relationship.

I hereby authorize investigation of all information contained in this application and also authorize full disclosure of my present and prior work records by an employer.  I understand that employment arising out of this application is contingent upon the results of this investigation.  I hereby release any employer from any obligation to provide me with written notification of any information disclosed.  I understand that this may include a record of disciplinary action assessed by the employer. I hereby release the Girl Scouts and all agents of the Girl Scouts from liability for acts performed in good faith and without malice in connection with evaluating my application, my credentials and qualifications.  I hereby release from liability any and all individuals and organizations, any firm, institution or court, who release data pertinent to the review of my application in good faith and without malice concerning my professional competence, ethics, character or other qualifications.

I further understand that the Girl Scouts of Southeastern Michigan (“GSSEM”) requires a background check, and that hiring is contingent upon receipt of satisfactory results.

Michigan law provides that disabled persons are entitled to certain legal rights including, where appropriate, accommodation.  If you are disabled and need accommodation, you must notify GSSEM in writing of the need for accommodation within 182 calendar days of the date you know or should have known of the need for accommodation.  Failure to give timely written notice of the need for accommodation may result in loss of legal rights under Michigan law.

I agree that if I am employed by GSSEM, the employment relationship is “at-will” which means that either GSSEM or I may terminate the employment relationship at any time with or without cause or notice.   I understand and agree that no manager, supervisor or representative of the GSSEM has the authority to enter into any agreement for employment for any specified period of time or enter into any agreement contrary to any information in this Applicant Statement.   No other practice, procedure, written or oral policy or statement by anyone, including other management personnel, can alter the at-will employment relationship.  I further recognize that if I am employed by GSSEM, I will receive compensation and benefits and be subject to rules and regulations; but I agree that such compensation, benefits, rules and regulations are subject to change by GSSEM with or without notice to me.  I acknowledge that my assigned work hours and place of work may be modified by GSSEM.

I understand and agree that any claim I may wish to file against GSSEM or any of its employees or agents in regard to my employment application, employment or termination of employment (including but not limited to any claim for any tort, discrimination, breach of contract, violation of public policy or statutory claim) must be submitted for binding and final arbitration before the American Arbitration Association (“AAA”). I also agree not to file any notice of intent to arbitrate or claim for arbitration more than 180 calendar days (or in less time if any statute of limitation so requires) after the event and/or employment practice or action complained of and to waive any state or federal statutes of limitation to the contrary (except those requiring a shorter period).  While the statute of limitations for claims arising out of an employment action may be longer than 180 calendar days, I agree and understand that any employer action for which a federal or state court would be authorized to grant relief in a lawsuit is barred if a notice to arbitrate is not filed within the 180 day period (or in less time if any applicable statute of limitation so requires).  I understand and agree that the 180 day period (or applicable shorter period) will not be extended for any reason, including continuing violations.  This provision does not prohibit the timely filing of a charge under federal law with a federal agency and the agency’s right to investigate is maintained.  However, filing a charge or claim with an administrative agency, including the EEOC or internally with GSSEM does not toll (hold in abeyance) the 180 calendar day period for me to file a notice to arbitrate and if I wish to obtain relief, I must file a notice to arbitrate within 180 days (or any shorter period if applicable law requires) of the complained of action.

I have read and understand and agree to the above statements and conditions of employment.