Working Men’s College Corporation

Chair Application Form.

Chair and Appointed Governor Application.

Please complete the details below and return the form to the Clerk to the Corporation (Bill Barker), Working Men’s College, 44 Crowndale Road, NW1 1TR. Email:

  1. NAME: (Mr, Mrs, Miss, Ms) (*Please circle that which applies)

FIRST NAMES:……

SURNAME: …………

  1. ADDRESS: ……………

………

POSTCODE: ……

  1. TELEPHONE: (Home)…… (Work): ……….

Mobile: …………………………

Email: ………………………@......

  1. NATIONALITY: ………
  1. OCCUPATION: …….
  1. Please attach:
  • an up to date CV with your application, and
  • a covering letter /statement which sets out how your skills and experience match those set out in each section of the person specification, and
  • why you would like to take up the post of the Chair of WMC.

Please note that all members of the Board are required to undertake the ETF Prevent Duty training module.

9.Please refer to Article 44 of the Memorandum and Articles of Association of WMC Corporation concerning the disqualification of governors (Annex 1). A prospective governor should consider the provisions set out at Annex 1, so as to decide whether to proceed with an application; and if proceeding to apply, declare any impediment (eg. bankruptcy, mental disorder) to their capacity to serve on the Board of Governors of WMC Corporation in a covering letter to the Clerk to the Corporation.

10.Please complete the Diversity Monitoring Form which is attached - (Annex 2)

Declaration:

I confirm that I wish, and am eligible, to apply for membership of the Working Men’s College Corporation as an Appointed Governor. I understand that if I am appointed, my membership of the Corporation will automatically cease once I cease to be a Governor.

Signed:______Date: ______

Print Name: ______

Referees.

Please provide the names and contact details of 2 referees to support your application.

We will pursue these before interview for applicants who are shortlisted for interview..

At least one of these must be provided in a professional capacity.

Name Referee 1: ______

Capacity: ______

Address: ______: Post Code: ______

Email: ______@______

Telephone: ______

Mobile: ______

Name: Referee 2: ______

Capacity: ______

Address: ______Post Code ______

Email: ______@______

Telephone: ______

Mobile: ______

Please reply to the Clerk to the Corporation by21February 2018

Bill Barker, Clerk to the Corporation

Working Men’s College

44, Crowndale Road

NWI ITR

Annex 1

Memorandum and Articles of Association of the Working Men’s College Corporation:

The attention of prospective governors is drawn to Article 44 concerning the disqualification of governors. A prospective governor should consider the provisions below and declare any impediment to their capacity to serve on the Board of Governors of WMC Corporation.

Article 44:

Disqualification and removal of Governors

The office of a Governor shall be vacated if:-

(a)he or she becomes prohibited by law from being a Governor; or

(b)he or she becomes bankrupt or makes any arrangement or composition with his or her creditors generally; or

(c)he or she is, or may be, suffering from mental disorder and either:-

(i)he or she is admitted to hospital in pursuance of an application for admission for treatment under the Mental Health Act 1983, or in Scotland, an application for admission under the Mental Health (Scotland) Act 1960; or

(ii)an order is made by a court having jurisdiction (whether in the United Kingdom or elsewhere) in matters concerning mental disorder for his or her detention or for the appointment of a receiver, curator bonis or other person to exercise powers with respect to his or her property or affairs; or

(d)he or she resigns his or her office by notice to the Corporation (but only if at least two Appointed Governors will remain in office when the notice of resignation is to take effect); or

(e)being an Appointed Governor he or she ceases to be a member;

(f)being a Nominated Governor, the terms of his or her appointment so prescribe; or

(g)without prejudice to the foregoing, if any of the matters set forth in subsection (1) of section 72 of the Charities Act 1993 (dishonesty offence, insolvency matters, removal by Commissioners or Court) shall apply to him or her, subject always to the remaining provisions of that section; or

(h)he or she is removed by a resolution of the members requiring special notice under section 303 of the Act.

Annex 2.

DIVERSITY MONITORING FORM
The Board aims for its composition to be reflective of the community it serves. Monitoring the diversity of the WMC Board is an important part of its commitment to Equality, Diversity and Inclusion. The information you provide will help us to achieve this.
Please complete this form and return it with your application form.
ｷ1Date of birth: ……………………………………
ｷ2Gender: ………………………………………………………..
ｷ3Ethnicity - please tick the most appropriate box below to describe your ethnic group or origin.
Asian or Asian British:Black or Black British
Asian BritishBlack British
Pakistani Black Caribbean
IndianCongolese
BangladeshiEthiopian
Other Asian Background -Black African
Please give further details…Somalian
Nigerian
Eritrean
ChineseAny other black background
ChinesePlease give further details …………
Mixed:White:
White and Black CaribbeanBritish
White and Black AfricanIrish
White and Black AfricanWhite Greekor Greek Cypriot
White and AsianWhite Turkish or Turkish Cypriot
Other MixedWhite Albanian
Please give further details….. White Kosovan
Gypsy/Roma
……………………………..Traveler of Irish Heritage
Any other white background
Please give further details ……………………………
Other Ethnic Group:
Any Other Ethnic Group
Prefer not to say/Refused
Please give further details …………………………………………………………..
ｷ4Do you consider yourself to have a disability?(WMC is committed to ensuring that people with disabilities are supported and encouraged to apply for membership of the Board.
Yes No
If you wish to provide any additional details please do so below:
......
NB. The Disability Discrimination Act 1995 defines a disability as:
“a physical or mental impairment which has substantial and long-term (lasting more than 12 months) adverse effect on your day to day living.”
For applicants with a Physical, Sensory or Visual Disability:
Please indicate in this section if you need any assistance because of a disability you may have. Please state carefully what help you may need, either at the interview stage or in the performance your duties as a member of the Board.
………………………………………………………………………………….
ｷ5If you wish you may disclose information about yourself in this section:
Religion: ………………………………………………………………………………
ｷ6Is there anyone who relies on you for day to day care and attention?
Yes No
If Yes, please specify (children, partner, family member etc): and state whether this is likely to have an impact on your ability to undertake the duties of a member / Chair of the Board).
………………………………………………………………………………………………….
Signature:______Date: ______