JLS 2015, Sangam

WORLD ASSOCIATION OF GIRL GUIDES AND GIRL SCOUTSWorld Bureau, Olave Centre, 12c Lyndhurst Road, London, NW3 5PQ, England + 44 (0) 20 7794 1181

Fax: + 44 (0) 20 7431 3764

e-mail: wagggs@wagggsworld.org

JULIETTE LOW SEMINAR
8 – 15 February 2015
Sangam, Pune, India

REGISTRATION FORM
(to be filled in by the participant)Name of Association: ..........................................................................................................................
The National Organization of .............................................................................. (Country)

Form to be completed and returned via e-mail by 30 November 2014 to: tirian@wagggs.org
Fee for the event is £380 GBP. (Includes all meals, accommodation and programme)

Personal Details
Name: .......................................................................................................................................................
Home address: .........................................................................................................................................

Home Telephone Nº: ........................................................ Mobile Phone Nº:...............................
Personal E-mail address:………………………………………………………………………………….
Date of birth: .............................................................................................................................................
All information will be sent to you by e-mailHow is your access to the Internet?
Easy

Irregular

Difficult

None

None

Basic

FluentEnglishFrenchSpanishLanguages spoken (please X as appropriate):

Other languages spoken: .........................................................................................................................
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JLS 2015, Sangam
PresentOccupation:…………………………………………………………………………………………....

LeadershipExperience:……………………………………………………………………………………………………
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Do you need a visa to enter India? (please X as appropriate):
Yes

NoEmergency Details
Person to be contacted in case of emergency: ......................................................................................
Name: ......................................................................................................................................................
Address: ...................................................................................................................................................

Home Telephone Nº: ........................................................ Mobile Number: .................................
E-mail address:.........................................................................................................................................

Girl Guiding/Girl Scouting BackgroundPresent position in National Organization: .............................................................................................
Past involvement in Girl Guiding/Girl Scouting. Please give a brief summary:..................................................................................................................................................................
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Other international events attended: ......................................................................................................
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JLS 2015, Sangam
Why do you want to attend the Juliette Low Seminar? .........................................................................
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How do you plan to put into practice the skills and knowledge you will gain during the JulietteLow Seminar for the development of Girl Guiding/Girl Scouting in your Association? Please
discuss and agree on this with the Chief Commissioner.
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Signature of participant ...........................................................................................................................
Date: .......................................................................................................................................................

Association E-mail address: ....................................................................................................................

National Commissioner/Chief Commissioner ........................................................................................
Signature: .................................................................................................................................................
Date: .......................................................................................................................................................

16 October 2014