Tanzania 2017 Leader Application Form

Tanzania 2017 Expedition
www.int-scout.org.uk
LEADER Application Form – WAVE 2
Application Process
This form must be completed and returned to the address at the end, by Sunday 3rd May 2015. All forms will then be
reviewed, and a restricted number of applicants will be invited to a Leaders weekend on Friday 29th – Sunday 31st
May 2015 (Location to be confirmed). The Leaders weekend forms a very important part of the leader recruitment
process. There will be a charge of £20 for this weekend, payable in cash upon arrival.
Please read the accompanying Tanzania 2017 Leaders Q&A before completing this form, and make sure that a copy
of this is passed to the leader completing your reference.
If you have any questions on completing the form, please contact the core team leaders, using the details at the end
of the form. If you run out of space on any section, please continue on a separate sheet. This form can be filled in
electronically and e-mailed to macawleader@hotmail.com (especially if you are getting close to the closing date).
However, the signed original must be then sent in the post.
Please mention any relevant experiences, whether they are Scouting / Guiding / Personal or Family.
Personal Details
Surname ___________________________ Full First Names _______________________________________
Known as (Nickname) ______________________ Special Dietary Requirements ________________________
Date of Birth ___________________________ (Max 01/01/1997)
Male or Female
Group / Unit _____________________________________________________________
Are you involved in (Circle all that apply) - County / District / Explorers / Scouts / Cubs / Beavers / Young Leaders
Which Scout District / County _________________________________________
Which Group / Unit _____________________________________________________________
Full Postal Address ________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Tel ________________________________________ Mobile ______________________________________
E-Mail Address ________________________________________________
A lot of communication will be by e-mail, therefore it is essential to have an e-mail address.
Applicants Signature ______________________________________
About You:
Please list any international experiences that you have participated in, or countries that you have visited. Please
mention and indicate any relevant experience, whether Scouting / Guiding / Personal or Family.
In the last 12 months, approx. how many nights have you spent under canvas? ____
What is your Scouting or Guiding experience to date? Please include details of which sections you have been a
member of, what major awards you have achieved and details of camps you have attended. If this is a big list, filter it
down to the events you feel are the most significant to you.
What do you feel is your greatest achievement in life to date?
What do you expect your role to be within your team?
What do you think your leadership style is?
What do you expect from this expedition?
Applicant's Personal Statement
Why do you want to visit Tanzania in 2017? What do you think you can offer the expedition team? Please include any
skills or qualifications that may be useful to the team.
Medical Information
Before completing this section, please read the Medical section in the Tanzania 2017 Leader Q&A document. Please
remember that we must have absolute full disclosure of medical information.
If you do not want your referee to see this sheet, it may be put in a sealed envelope and included with your
application. Please feel free to contact and discuss any item here with a member of the core leader team.
Please list any known medical issues that you have, and treatment being received:
Please list any tablets / injections / other medications that you are currently taking:
Please list any disabilities or list any other medical information that may be useful to the core leader team:
Reference; To be completed by a leader
Applicants - Please ask another leader (who cannot be a family member, another applicant, or a member of the core
leader team) to complete the following section, and to then post the completed application form to the address at the
bottom (applicants – it helps if you provide a pre-addressed stamped envelope to the person providing your
reference). Please remember to give a copy of the “Tanzania 2017 Leader Q&A” document to your referee for their
background information.
Referee - The information given in this section is to remain confidential from the applicant, and must be sent direct to
the address below, preferably with the completed application form.
Referee Name ______________________________
Applicant Name ___________________
Scouting / Guiding Position held ______________________________________________________
Length of time you have known the applicant ____________________________________________
Telephone contact number ____________________ E-mail Address __________________________
Please provide a character reference for this applicant. Please state how long they have been involved in Scouting /
Guiding, and why you think this applicant would be (or not be) suitable for an expedition to Tanzania, as outlined in the
“Tanzania 2017 Leader Q&A” document (available from www.int-scout.org.uk). If you would like to discuss this with a
leader direct, please call Julian Sore, as below.
Referee Signature ______________________________________________
Please can you complete the following information, so that we can inform them of the applications from within their
areas.
DC Contact
Name _______________________________
District/Area __________________________
Contact Tel ___________________________
E-mail Address ________________________
County International Advisor Contact
Name __________________________________
District / Area ____________________________
Contact Tel ______________________________
E-mail Address ___________________________
Thank you for your help. Please return this form as soon as
possible (Closing Date is Sunday 3rd May 2015) to
Julian Sore, Tanzania 2017, 7 Monxton Road, Andover, Hants. SP10 3LY
Applications can be E-mailed to macawleader@hotmail.com, with the original then posted.
If you would like to discuss this with the expedition leader, please contact
Julian Sore: Eve 01264 391186 Mob 0778 9966440 www.int-scout.org.uk