Board Application Form - Your Leisure

Your Leisure Kent Limited Board Application Form

Name *

First

Last

Email *

Phone

What kind of business skills do you consider you could bring to the Board?

What other experience or skills do you feel you offer? Please list any professional qualifications or memberships of professional associations, if any.

Are there any areas of the organisation’s work in which you would like to be involved and feel you could contribute?

Do you hold any position within other organisations i.e., directorships, governor, or trustee? If so, please give details.

Declarations

I am not closely related to any employee of Your Leisure Kent Limited or client organisation to whom they provide services
I am not bankrupt, and I have not made a voluntary arrangement with creditors
I am not disqualified by the Department of Trade and Industry from being a company director
I am not closely related to an elected member of a client local authority
I have/have not* been a director of a company which has gone into insolvent liquidation (if you have declared that you have been a director of a company which has gone into insolvent liquidation, please give details on a separate sheet)
I am not incapable of acting by reason of mental disorder for which I am admitted to hospital under the Mental Health Act 1983 or have a Court Order relating to the illness or to appoint someone to look after my property or other affairs

Rehabilitation of offenders: Do you have any convictions?

The nature of Your Leisure Kent Limited’s work may bring you into contact with vulnerable people or information about vulnerable people. Therefore, our work is exempt from Section 4(2) or the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation of Offenders Act (Exemptions Order) 1975. This means that you are NOT entitled to withhold information relating to any convictions you may have had. It is a requirement for all Board members to be DBS checked.

If yes, please give full details on a separate sheet and send with the application. This information will be treated as confidential and will not necessarily preclude you from becoming a Board member.