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Name
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BurnerName
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Email
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Phone Number
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Please list the burns you have attended and number of times for each.
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What leadership roles have you held at a burn?
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What volunteer positions have you held at a burn?
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Please list any lead positions you're interested in for POrtalBurn 2016, in order of preference.
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What are your qualifications for these positions?
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What, if any, are your challenges to fulfilling any of the responsibilities for the positions you listed?
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Is there anything you would like to tell us that we did not ask?
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