To help us place you in the best project for your skills and interests please complete the following few questions.

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* 1. Your name

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* 2. Your membership number

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* 3. Your email address

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* 4. Your QGA Mentor's name

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* 5. Your current roles in guiding

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* 6. Your date of birth

Date

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* 7. By what date do you need to have completed your award?

Date

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* 8. Please describe the skills and knowledge you have already which you feel you could bring to a Region level project.
These could either skills you have acquired through doing your award, through the rest of your guiding career or outside of guiding.

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* 9. Is there are specific area of work you have an interest in?
We cannot guarantee that there will be an opportunity in this area, but at least it will give our Lead Volunteers an idea of what skills we have to draw on at this point.

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* 10. Is there any additional information would you like to tell us at this point?

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