Seeking Trustees

Trustee Recruitment

General Information

Name *

First

Last *

Last

Where did you see this post advertised? *

Home Address *

First line of address

Second line of address

City

County

Postcode

Country

Home Phone Number

Mobile Phone Number

Email Address *

Motivation

Please explain why you would want to become a Trustee of Pie Factory Music: *

Do you have any previous Trustee or charity experience? *

Yes

If yes, please give details:

Details of past Trustee / Charity experience

Suitability & Conflicts of Interest

Are you aware of any matter, which might call into question your integrity as a trustee or bring you / or Pie Factory Music into disrepute? These may include criminal investigations or convictions, financial affairs and reputation? *

Yes

Are you aware of any matter, which may present a conflict of interest if you were to be elected as a Trustee? These may include personal relationships or membership of organisations? *

Yes

If the answer is yes to either of the above questions please give details here: *

Criminal Offences

Do you have any unspent cautions, convictions, police reprimands or warnings? *

Yes

If the answer is yes to the above question please give details here: *

Is there anything else you'd like to tell us?

Reference 1

Please give details of people who can comment on your suitability for this role. Please note that references from relatives are not acceptable.

Name *

First

Relationship to you *

Organisation and Position

Address *

City

State/Province

Zip/Postal

Country

Email Address *

Phone Number

Reference 2

Please give details of people who can comment on your suitability for this role. Please note that references from relatives are not acceptable.

Name *

First

Relationship to you *

Organisation and Position

Address *

City

State/Province

Zip/Postal

Country

Email Address *

Phone Number

Declaration

I confirm that the details given in this form are correct and understand that any false declaration may result in my removal from the Board of Trustees.

Yes

I confirm that: 1. I am aged 18 years or over at the date of this election or appointment 2. I do not have an unspent conviction relating to any offence involving deception or dishonesty 3. I am not an undischarged bankrupt (or subject to sequestration in Scotland) or have current composition or arrangement including an individual voluntary arrangement (IVA) with your creditors 4. I am not subject to a disqualification order under the Company Directors Disqualification Act 1988 or to an Order made under section 429(b) of the Insolvency Act 1986 5. I have not been removed from the office of charity trustee or trustee for a charity by an Order made by the Charity Commissions or the High Court on the grounds of any misconduct or mismanagement (or equivalent in other jurisdictions) 6. I am not disqualified from being a company director 7. I am not disqualified under the Protection of Vulnerable Adults List 8. I am not barred by the Disclosure and Barring Service (DBS) from work involving contact with children or vulnerable adults (regulated activity). 9. I will, if elected, undertake a Disclosure and Barring Service check 10. I have read the Charity Commission booklet CC3: The Essential Trustee – what you need to know https://www.gov.uk/government/publications/the-essential-trustee-what-you-need-to-know-cc3/the-essential-trustee-what-you-need-to-know-what-you-need-to-do 11. I understand and am able and willing to commit necessary time, preparation and effort to the proper discharge of the responsibilities of a trustee 12. I hereby explicitly consent to Pie Factory Music holding my personal details within a manual or electronic filing system in relation to the Data Protection Act 1998

News

General Information

Motivation

Skills & Interests

Suitability & Conflicts of Interest

Criminal Offences

Reference 1

Reference 2

Declaration