National Activities County Pre-Qualification Authorisation – NA 01 ACTIVITY PRE-REQUISITE COUNTY AUTHORISATION THIS FORM MUST BE USED IN CONJUNCTION WITH THE NATIONAL ACTIVITIES CENTRAL BOOKING FORM WHEN SPECIFIED PLEASE PRINT IN BLOCK CAPITALS 1. ACTIVITY DETAILS Activity Booking Code: Activity Date: Activity Name:
2. COUNTY ACTIVITY DETAILS County Name: County Activity Name: Location: Date: Number of Participants:
Teams / Individuals
3. RESULT DETAILS – 1st Place (see “NA02 – Notes” document available from www.scouts.ie) Name of Group: Section (if applicable):
4. RESULT DETAILS – 2nd Place (see “NA02 – Notes” document available from www.scouts.ie) Name of Group: Section (if applicable):
5. RESULT DETAILS – 3rd Place (see “NA02 – Notes” document available from www.scouts.ie) Name of Group: Section (if applicable):
6. RESULT DETAILS – 4th Place (see “NA02 – Notes” document available from www.scouts.ie) Name of Group: Section (if applicable): 7. COUNTY AUTHORISATION THIS SECTION CAN ONLY BE SIGNED BY THE COUNTY PROGRAMME CO-ORDINATOR / COUNTY COMMISSIONER I confirm that the above County held a Pre-requisite Activity to allow those Groups named above to participate in the National Activity detailed in Section 1. I confirm that the County is in good standing in the Association for the current Census Year and will adhere to the relevant Policies of Scouting Ireland when on the Activity. Signed (CPC /County Commissioner):
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Date: _______________________