Trustee Application Form

Full Name *

Home address and post code *

Home telephone number

Mobile number

Email address *

Occupation *

Please can you give details of any qualifications you have

Which of the following skills or experience could you bring to the board?

Charity Law and Governance

Human Resources

Fundraising

PR and marketing

Business Management

Health and Social Care

Experience with learning disabilities/disabilities

Finance/Accounting

Camphill and Camphill Ethos

Please provide some information about why you would like to become a Trustee of Camphill Holywood and how you think your own skills and experience would enable you to fulfil the role of a Trustee *

Declaration of eligibility: I declare that... (please check the boxes to confirm) *

I am over 18

I am not an undischarged bankrupt

I have not previously been removed from trusteeship of a charity by a Court of any Charity Commission or charity regulator

I am not under any disqualification under the Company Directors' Disqualification Act 1986

I have not been convicted of an offence involving vulnerable groups, deception or dishonesty

I have not entered a composition or arrangement with creditors, or have an individual voluntary arrangement (IVA) and I am not insolvent

I undertake tofulfil my responsibilities and role as a trustee of Camphill Community Holywood in good faith and in accordance with the law and within the organisation's objectives and Code of Conduct

I do not have any financial or other interests in conflict with the interests of Camphill Community Holywood (either in person or through family or business connections) except those that I have/will formally notify the community of in a conflict of interest statement. I will specifically notify any such interest at any meeting where Trustees are required to make a decision which affects or may affect my personal interests and I will absent myself entirely from any decision on the matter and not vote on it.

Management Council Expression of Interest Form

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