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Sangam World Centre
Community Programme Amy Bush
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Personal Details
FullName
Ge n0etI
Preferred Name
Natronalrty
Do you have any olher nalionalitres/passporis?
PassporUTravel Document Number
Date of Bidh 1DD/MtM/yy)
Age In Years
Address
Country of Residence
Telephone No
[4obi]e No
Skype lD
Email
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conlact details wthin the WAGGGS netwo.k? yES/NO
lf selected may we share your emailcontact wiih your fe
ow partc pants? yES/NIO
Ho"! d d you 't,to ou aboul t1s ooponu, tty?
Photo
Please attach a photo of yourself, so we can ger ro Know you better
Term Dates
1 September
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24 Novenbet 2OjS
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Week programme
ll se ected. do you want to be considered ior schotarsh p?
Full Programme Fee Scholarship
from Amy Bush Bursary
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if you answered yes above please ndicate
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contfibute frnanciaIy to your
an0 what your l\lember Organisatron (rf app rcable)
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contnbute I nancrally to lhe expenence
Please Note
Wor/d Centres can receive up to 50+ apphcal ons for posrtions
When fil ng olrt lh s apptcatron
form p ease keep this in mind and ans!.rer rn one paragraph on y for
each questron
ldoo o,r'narer!
I Selrpncec
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Girl Guiding/Girl Scouting Experrence
Name of Gtrt Gu de/cirl Scoul association of which you are
a member
Present pos hon rn Girl cuiding/Gtrl Scouting
Are you an aclrve rnember? yES/NO
have you votunleered/worked in another World Gurde or Scout Centre? yES/NO
li yes, please specify
flave you stayed at or attended an evenUprogramme at a Word Cenke? Whal
evenUprogramme?
Have you vrs ted a Wortd cuide or Scout Centre (specify whtch
centre and when)?
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Whal is your understandrng ofthe mission and vision ofWAGGGSt
Give a brief descnption of your Girl cu ding/Grrl Scoutlng Experience
Other Relevant Experience
Please give a brief descriptlon of your experience In the fotowing fretds
International or Cross-Cultural Ex0erience
Educatron/Tratntnq Recetved
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Work/ Professional Exoerience
Team Work
Personal Statement
Descflbe vourself as a person
Descnbe vour leadership and social sktlls
ramme?
choice your placement
1 beinq vour first
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be based upon your tntere
Working with chitdren
Working with p
Working with young people
Health issues
Environmentalissues
Working wrth peopl who are
Sustainability
differently-abled (h
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Teaching general
Working with men
end Violence
Teachrng English
Againsl Women a
Girls
Crafts
Siop the Violence
Dance and Music
Free Being Me Ca
Women s empowerment
Oiher
Primary health care
Other 2l
Health care
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Whal do vou lhtnk wti be tne
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manaqe lhe challenoe?
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What rs vour understandino of Communitv Leadersh
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Police Record Check
In your home country have you had a poljce records check? yES/NO
ir yes, please supply evidence such as a certificate
Answeflng no to this question wi/l not exclude you from being selected
bul we
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asK your
International Commissioner to research and then srgn off the form
References
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Please list two people that can be contacted as your referees One shoLrld
be a
Scouting person and one othef that is not your famiJy These people m
0e contacted to
provjde a reference for you.
Phone Number
EmailAddress
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International Commissioner Approval
Thrs
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acc-rale representalton ol
Who belongs to
Name ofWAGGGS Menbar Otganisatian
I have the reason to belreve the applicanl has rne necessary
ctearance w
country to work with children and young people I endorse
them to repres
our Member
Organisation through this experience We agree to support them
on their re rn !c spread
rnternatronal fflendship and share therr World Centre
Name of lntemationat Comnissioner
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Telephone of lntemational Commissioner
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Enail Address of htemational Comnisstonel
Date
Applicant's Signature
This application is a trite and honest represenlation of myself and my experience
Sangam World Centre may verify this information at their discretion. incl
my referees for more information and consuliing my national cjrl Guiding
organization.
Applicant s Signature
Please email this form to operations@sanqamwotldcentfe oro
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