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! style="width:6em" | Region:
| style="border-style: solid; border-width: 1px; border-color: gray;width:40px" | {{{field|region|mandatory|input type=combobox|values=East Midlands,East Of England,International,London,North East,North West,Scotland,South East,South West,Steering Committee,Wales,West Midlands,Yorkshire & Humber|size=30}}}
|-</br></br>
! Proposer:
| {{{field|proposer|mandatory|size=16}}}
| |||