Nominations Committee

Nominations Committee

NOMINATION FORM

The closing date for nominations is Wednesday 30 August 2017

If selected by our trustee boardto be put forward for election, the name and organisation of the nominator and nominee together with the information in parts 2 and 3 of this form will be provided to NCVO members (via NCVO’s website) to help them decide who to vote for.

Part 1 – tobe filled in by the nominator

1. Details of the candidate

Name
Organisation
Position in organisation
NCVO member number if applicable
Address
Email address
Landline number
Mobile phone number

2. Nominated by

Name
NCVO member organisation name
NCVO membership number
Position in organisation
Email address
Landline number
Mobile phone number

Part 2– to be filled in by the nominee

1.Your biography

Please attach an up to date CV to your application.

Relevant employment

Relevant voluntary activity

Other trusteeships/directorships

Any additional information

2.Summary skills and experience

The nominations committee collectively requires skills and experience as outlined in the person specification (please refer to the nominations committee role description).

Please tell us why you feel you are a suitable candidate for the role. Taking into consideration the person specification,please tell us how you meet the required skills/experience. Use no more than 600 words.

3.Election address to the members of NCVO

Please set out in no more than 200 words why you think you would make a suitable candidate for this role.

4. Confirmation of eligibility to be a committee member

Statement / X
I am over the age of 18
I am not

• an undischarged bankrupt;
• subject to an order made under section 429(2) of the Insolvency Act 1986;

I do not

• have an individual voluntary arrangement (IVA) to pay off debts with creditors

I have not previously been removed from trusteeship of a charity by a court, or the Charity Commission
I am not under a disqualification order under the Company Directors Disqualification Act 1986
I am, in the light of the above, not disqualified by S72 of the Charities Act from acting as a charity trustee

Please mark an ‘X’ in the box next to each statement to confirm your suitability.

Part 3– to be filled in by nominee

Diversity Monitoring

NCVO is committed to taking action to promote equality and to value diversity. To this end we would ask you to consider completing this optional diversity monitoring form.

Please select the relevant boxes by marking with an ‘X’

ETHNIC GROUP / X
Please choose one
section from A to E. Type an ‘x’in the box
in the right hand column next tothe description to indicate your culture and background / A. White / British
Irish
White other, please state:
B. Mixed / White and Black Caribbean
White and Black African
White and Asian
Other mixed background, please state:
C. Asian or
Asian British / Indian
Pakistani
Bangladeshi
Other Asian background, please state:
D. Black or
Black British / Caribbean
African
Other black background, please state:
E. Chinese or other ethnic group / Chinese
Other, please state:

Job description

SEXUAL ORIENTATION / Heterosexual/Straight
Gay woman/Lesbian
Gay man
Bisexual
Other
Prefer not to say
GENDER / Female
Male
RELIGION/BELIEF / Christian
Jewish
Muslim
Hindu
Sikh
Buddhist
No religion
Prefer not to say
Other, please state:
AGE GROUP / 16 -17
18 - 24
25 - 34
35 - 49
50 - 59
60 - 65
65 +
I CONSIDER MYSELF
TO HAVE A DISABILITY / Yes
No
If yes, would you like to tell us more?

Please return the completed form (no stamps required) to the following address

Company Secretary
NCVO
FREEPOST WC 4530
Society Building
8 All Saints Street
London N1 9BR

Or by email to

Deadline Wednesday 30 August 2017