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* 1. First Name:

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* 2. Surname:

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* 3. Membership Number

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* 4. Your details

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* 5. Current guiding county

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* 6. Current roles in Girlguiding (titles and start date)

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* 7. Previous roles in Girlguiding (title and start/end dates)

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* 8. Have you held a County or Region role previously?

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* 9. If Yes to question 8, please give brief details: (title, start/end dates, key achievements)
(Please note, your County Commissioner will be asked to provide a reference for your application)

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* 10. Please provide the name and membership number of one other Girlguiding member who holds a Division or County role and who would be willing to provide a reference on  your behalf

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* 11. In three words how would you describe yourself on a good day?

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* 12. In three words how would you describe yourself on a bad day?

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* 13. Why do you wish to be considered for this role?

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