Application form for prospective Board Members

Application form for prospective Board Members
Please complete this form (in BLOCK CAPITALS and BLACK INK) if you wish to be
considered for membership of the Board.
Section A:
Personal details
Date of Birth:
Home Address:
Tel. No. Home:
Tel. No. Work:
Post Code:
Email address:
If working, please indicate whether we may email or phone you at work
Email at Work
Phone at work
Please return your completed application form to: Theresa McLintock, PA/Secretary
Corporate Services, Grampian Housing Association, 74 Huntly Street, Aberdeen,
AB10 1TD. Information from the application form will be used as the basis on which to
select an initial shortlist.
Section B:
Details of any current employment/business or voluntary role
Name of business/organisation:
Type of business/organisation:
Address of business/organisation:
Your position or role:
Post Code:
Brief description of your responsibilities:
Section C:
Your experience
Please give details of your professional/career background (continue on a separate sheet if
necessary) and in particular provide details of any involvement on a paid or voluntary basis
in any business or voluntary organisation and the size and scope of the business or
voluntary organisation concerned.
Section D:
Your assessment of areas of expertise
Your experience cont’d
How experienced or knowledgeable do you rate yourself in the following areas (1 being
very experienced and 5 being not experienced at all)?
Please note, we are not expecting you to be an expert in all these areas!
1 2 3 4 5
Housing issues
Registered social landlords
Social housing and related policy issues
Management of housing
Housing law
Housing design, construction or maintenance
Business strategy
Business planning and business management
Financial & treasury management
Capital financing and banking
The private business sector
Staffing and organisational development and HR management
Public relations, media and communications
Information technology
Project management
Renewable energy, energy supply
Marketing & Sales
Tenant and community issues
Community involvement initiatives
Community development
Tenant participation
Equal opportunities and diversity practice
Commercial and business law
Community regeneration
Economic regeneration or development
Grant funding
Social economy and enterprise
Section E:
Please list any particular qualifications you may have which are relevant to your board
membership application.
Section F:
Where gained:
What will you bring to the Board?
Why do you want to be a Board Member?
Please tell us about why you want to be a Board Member. In completing this section,
please refer to the Board member characteristics set out in the box on pages 5 and 6 of
this Pack and think about what has prompted you to consider board membership.
What do you think you will bring to the Board?
Please tell us about the qualities, abilities and skills you think you will be able to
contribute to the Board. Particularly tell us about how your previous experiences will
help you to be an appropriate Board member. In completing this section, you might
want to refer to the Board member person specification. You may want to highlight
how your experience and/or qualifications make you particularly suited to being on the
Please continue on one further sheet if necessary
Section G:
There are certain people who cannot be or might not be suitable to be members of a board.
Please check the following and which would prevent someone from being a member of the
Board. Where none of these apply, please sign to confirm your compliance in these areas.
You will not be eligible to be a Committee Member and cannot be appointed or elected as such
- you are an undischarged bankrupt; or
- you are subject to an arrangement with your creditors; or
- in the opinion of a qualified medical doctor, you would be unable to attend Committee
Meetings for a period of 12 months because of incapacity due to a physical or mental illness, or
- you have been convicted of an offence involving dishonesty which is not spent by virtue of the
Rehabilitation of Offenders Act 1974 or an offence under the Charities and Trustee Investment
(Scotland) Act 2005,
- you are a party to any legal proceedings in any Court of Law by or against the Association, or
- you are or will be away for a period of 12 months and would be unable to attend the
Committee Meetings during this time, or
- you have been removed from the Committee of another registered social landlord within the
previous five years, or
- you have resigned from the Committee in the previous five years in circumstances where your
resignation was submitted after the date of your receipt of notice of a special committee meeting
convened to consider a resolution for your removal from the Committee in terms of Rule 44.5, or
- you have been removed from the Committee in terms of Rules 44.4 or 44.5 within the previous
five years; or
- you have been removed or suspended from a position of management or control of a charity
under the provisions of the Law Reform (Miscellaneous Provisions) (Scotland) Act 1990 or the
Charities and Trustee Investment (Scotland) Act 2005; or
- you have been removed from the office of charity trustee or trustee for a charity by an order
made by the Charity Commissioners for England and Wales under section 18(2)(i) of the
Charities Act 1993, section 20(1A)(i) of the Charities Act 1960 or section 20(1) of that Act (as in
force before the commencement of section 8 of the Charities Act 1992) or by Her Majesty’s High
Court of Justice in England on the grounds of any misconduct in the administration of the charity
for which you were responsible or to which you were privy, or which your conduct contributed to
or facilitated.
- a disqualification order or disqualification undertaking has been made against you under the
Company Directors’ Disqualification Act 1986 or the Company Directors Disqualification
(Northern Ireland) Order 2002 (which relate to the power of a Court to prevent someone from
being a director, liquidator or administrator of a company or a receiver or manager of company
property or being involved in the promotion, formation or management of a company).
I declare that the above information on this form is correct and understand that if appointed, I
will be liable to action including removal from the Board and / or criminal action should I
knowingly give false information.
………………………………………. Date:………………….
Applicant Monitoring Questionnaire
Please complete this form so that we can monitor the diversity of those applying for board
membership. This form will be kept separate from your application form, and has no part in
the selection process.
Please tick appropriate boxes
Ethnic Group
Do you regard yourself as:
 Black – African
 Chinese
 Scottish
 Black – Caribbean
 Indian
 Irish
 Black – Other (please describe)
 Bangladeshi
 White – Other (please describe
 Pakistani
------------------------------------ Other (please describe)
I am:
 Female
 Male
Do you consider yourself to be disabled?
 Yes
 No