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* 1. Full Name

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* 2. Organisation Name

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* 3. Job title or position

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* 4. Telephone number

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* 5. Email address

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* 6. What sector do you work in?

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* 7. What experience do you have of social impact measurement?

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* 8. Which of the following best describes what you can bring to SIMNA?

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* 9. Are you interested in becoming a permanent member of the Steering Committee or an adviser to the group?

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* 10. What attracts you to SIMNA?

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