Independent Board Member
London Area Board
Personal details
If you need this form in another language or format, please contact us.
Please return your completed form:
By e-mail to: michael.anderson@watmos.org.uk
By post to:
Michael Anderson
Group Human Resources Manager
Watmos Community Homes
116-120 Lichfield Street
Walsall
West Midlands
WS1 1SZ
Personal Details
Title
Forenames
Last Name
Address
Telephone
E-mail Address
Home:
Work:
Mobile:
Application Form - Page 1
Please briefly outline:


What attracts you to Watmos Community Homes?
What you feel you can bring to the Watmos Community Homes as an Independent Board Member?





r
Do you feel you can give the following time commitment?:
 Attend a minimum of 4 Board evening meetings per year
 Attend other special meetings of the Board
 Attend the occasional ‘away day’ or ‘away weekend’
 Attend the occasional training/briefing session
 Attend sub-committee meetings as required.
Application Form - Page 2
Are you a Councillor on Lambeth or Walsall Council (or have you been a Lambeth or Walsall
Councillor within the last 4 years)?
☐ Yes
☐ No
Are you an employee or an officer (i.e. a director) of a company controlled by Lambeth Council or
Walsall Council?
☐ Yes
☐ No
Are you a tenant of Watmos Community Homes (or prior to transfer, Lambeth or Walsall Council)?
☐ Yes
☐ No
Are you a leaseholder of Watmos Community Homes (or prior to transfer, the Council)?
(If
☐ Yes,
Yes you can not be an Independent London Area Board Member)
☐ No
(If Yes, you can not be an Independent London Area Board Member)
Have you read and understood the explanation of the work and the role of the Watmos Group Board
and/or London Area Board and the role of the Watmos Group Board and/or London Area Board
Members? Do you agree to accept and fulfil the role and responsibilities of a Watmos Group Board
or London Area Board Member?
☐ Yes
☐ No
Watmos Community Homes’ Rules state that no one can become or remain a Board Member at any
time if:
 They are bankrupt or subject to an agreement with their creditors;
 Or they have been convicted of an indictable offence within the last 5 years.
Do either of these apply to you?
☐ Yes
☐ No
If Yes, please state which one(s) and give further information
Application Form - Page 3
Have you read and understood the note about ‘Limitations on Board Members and Co-optees’?
(Please refer to the foot note at the end of this application form.)
☐ Yes
☐ No
Do you have any personal interest, or business interest, or undertake any activity which you may
need to declare? (Please refer to the foot note at the end of this application form (page 15)
‘Limitations on Board Members and Co-optees).
☐ Yes
☐ No
If Yes, please give further details:
Application Form - Page 4
Education and Quaifications
Precise Dates
From
To
Name of School,
College, University etc.
Qualification
Other Training
Include professional qualifications, recent short courses.
Dates
Professional Qualification or Training Attended
Grade
Application Form - Page 5
Relevant Employment Experience
Precise Dates
From
To
Name of Employer
Job Title and Brief Details of Responsibilities
Application Form - Page 6
Group Board Skills and Experience
The Watmos Group Board needs volunteers with a variety of skills, knowledge, understanding and
experience in order to fulfil its purpose. So as a member of the Watmos Group Board it is important to make
an assessment of the skills, knowledge, understanding and experience of the Board Members.
Please assess your level below 1 = low level and 4 = very high level
Board Skills Required by
Please outline and evidence how your skills and
Watmos Community Homes
experience are relevant to membership of the
Group
in space
order of
Group
PleaseBoard
use the
against each area to describe whatWatmos
your skills
andBoard
experience bring to the London Area
priority
Board.
Specialist skills or working
knowledge in accounting,
1 2 3 4
finance and financial planning.
Specialist skills or working
knowledge of the audit
function strategic housing
management.
1
2
3
4
Specialist skills or working
knowledge of community
enterprise.
1
2
3
4
Specialist skills or working
knowledge of leasehold
management.
1
2
3
4
Application Form - Page 7
Specialist skills or working
knowledge of resident
managed housing.
1
2
3
4
1
2
3
4
1
2
3
4
Understanding of
procurement processes
and contract management
1
2
3
4
Awareness of the wider
operating and political
environment within London
1
2
3
4
Understanding of value for
money.
Developing business
strategy and plans
Application Form - Page 8
Experience of being an
ambassador and the public
face of a group or an
organisation
1
2
3
4
Ability to foster a culture
that enhances commitment,
enthusiasm and excellent
performance from staff
1
2
3
4
Ability to contribute to the
development of the
Watmos Group’s vision,
values and objectives
1
2
3
4
1
2
3
4
Experience of building and
maintaining strong and
effective working
relationships with a wide
cross section of individuals
and communities
Application Form - Page 9
Understanding and
acceptance of the
responsibilities of a Board
director
1
2
3
4
Ability to constructively
challenge and hold the
Executive Management
Team to account
1
2
3
4
1
2
3
4
1
2
3
4
Ability to scrutinise the
organisation’s performance
Understanding of our
residents’ needs and
aspirations for the future of
their homes,
neighbourhoods and
services
Application Form - Page 10
Do you carry out any other work, paid or voluntary? This may include being on the committee of a
local voluntary group, a school governor, a regeneration body, or a Company Director for example.
Role
Organisation
Date
Equal Opportunities Monitoring
Equal Opportunities Monitoring – Strictly Confidential
Gender
Male ☐
Female ☐
Ethnic Origin
Do you consider yourself
to have a disability?
If yes, do you have any
special requirements to
enable you to attend
meetings?
Asian or Asian British - Bangladeshi
Asian or Asian British - Indian
Asian or Asian British - Pakistani
Asian or Asian British - Other
Black or Black British - African
Black or Black British - Caribbean
Black or Black British - Other
Chinese
Mixed - White and Asian
Mixed - White and Black African
Mixed - White and Black Caribbean
Mixed - Other
Other ethnic background
White - British
White - Irish
White - Other
Information refused
☐ Yes
☐ No
Please Click/Tick One
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
☐
References
Name
Name
Address
Address
Telephone Number
Telephone Number
E-Mail Address
E-Mail Address
Context regarding how you know the referee
Context regarding how you know the referee
Declaration
Watmos Community Homes
Application to become an Independent Board Member
I hereby apply to become an Independent Board Member and fully accept the role and obligations of joining
the Board and agree to be bound by the rules of Watmos Community Homes. I declare that to the best of my
knowledge and belief the information given in this form is correct.
Signed
Print Name
Date
Footnote
Limitations on a Board Member and Co-optee
The Homes and Communities Agency have very clear guidelines which restrict Board Members (and Cooptees) and their families gaining any personal benefit from their Board membership or employment.
These are described in Watmos Community Homes’ Probity Policy and affect the following;
- Board Members and Co-optees
- Employees
- People who have been Board Members, Co-optees, or employees, such as husband, wife, partner, parents,
grandparents, grandchildren, brother, sister or similar by marriage.
- Any business of which a Board Member, Co-optee or employee, or one of their family is an owner, partner,
significant shareholder, or is otherwise directly involved in its management.
The exemptions from this include;
- It is possible to re-house Board members/Co-optees or their relatives, provided that the person re-housed
fully meets the Watmos published lettings policy, and that the Board member/Co-optee has absolutely no
involvement in or influence over the decision making process. The Organisation must show that its
procedures and decision making are scrupulously fair.
- Board members/Co-optees who are tenants of Watmos can continue to benefit from Homebuy or Voluntary
Purchase Grants provided they meet the published criteria.
If you are unsure how the Probity Policy may affect you, please contact the Watmos Chief Executive.
Board members/Co-optees are expected to inform the Chief Executive if any circumstances arise in the future
that may constitute a breach of the Probity Policy.
References