Norfolk VCSE Sector Leadership Group

Nomination Form

Norfolk VCSE Sector Leadership Group

Nominee Name
Organisation (if appropriate)

Contact Details

These will not be made publicly available
Address
Phone / Email

Nominee Statement

Please provide a brief statement as to why you wish to be part of the VCSE Sector Leadership Group and what knowledge and expertise you feel you will bring.
This will be distributed ahead of the election. The statement is limited to 500 words. When we distribute these summaries they will be truncated to the first 500 words.

Nominee Declaration

I certify the following. That I am willing to stand to be part of the VCSE Sector Leadership Group. The information I have provided above is true to the best of my knowledge. I have read and understood the paper outlining the role of the group and of those appointed to the group. I am prepared to work as part of the system leadership group to the best of my ability for the benefit of the VCSE sector and Norfolk as a whole.
Name…………………………………… Signature ……………………………………………
Date……………………………….

Nominating Organisation

Any individual may stand as a candidate but they must be nominated by a VCSE organisation predominantly based in Norfolk. This means an organisation that has its registered office or main base in Norfolk or delivers more than 50% of its services in Norfolk. A VCSE organisation for these purposes is any registered or unregistered charity, any community interest company, any IPS or similar registered society fulfilling the ‘societies for the benefit of the community’ definition, community associations that have a governing document containing a clear public benefit purpose operating on a non-profit basis.
Name of Nominating Organisation /
Charity Number (if appropriate) / Company Number (if appropriate)
Organisation Address
Authorised Signatory
I certify the following. To the best of my knowledge the organisation named above meets the requirements to nominate a candidate to the VCSE Sector Leadership Group. That I am authorised to sign and submit this document on behalf of the above named organisation. That it is the organisation’s intention to nominate the above named individual to be elected onto the VCSE Sector Leadership Group.
Name…………………………………… Signature ……………………………………………
Date……………………………….

All nomination forms must reach Community Action Norfolk offices on the 25th of May 2017 to be included in the election.

Please return to Community Action Norfolk, Ambassador Way, Greens Road Dereham, and Norfolk NR203TL or by email to