Nomination Form / Leitrim Development Company / Leitrim PPN

Nomination Form for Leitrim PPN Members to be Elected onto the Board of Leitrim Development Company
Leitrim Development Company, is a community led Local Development Company and a registered charity. It seeks to promote, support, assist and engage in social and enterprise development to facilitate rural and urban regeneration while developing communities to benefit and promote from within.

The company is formed of a Board that comprises representatives from community and voluntary groups, state agencies and national social partners.

Please read and fill out this nomination form if you wish to be considered for a place on the board of Leitrim Development Company. The closing date for nominations is .....................
Page1: Eligibility Details

There are .............. vacancies on the board of Leitrim Development Company to be filled by Leitrim PPN members. The seats to be filled are:
- One male representative from the Carrick-on-Shannon MD
- One male representative from the Manorhamilton MD
- One female representive from the Ballinamore MD
Those wishing to be nominated for the ........... seats must:
- Be part of an organisation registered with Leitrim PPN.
- Be over 18yrs of age.
- Be willing to dedicate time to attend board meetings and related.
- Adhere to Leitrim PPN's Code of Conduct.
How do we choose who fills the vacancies?

When all nominations are received, we will review each nominee's eligibility and where more nominations are received for seats available, we will hold an online election for that vacancy. This will involve circulating your biography for Leitrim PPN members to cast their vote (there will be 1 vote per member group).

For more information on the role of aRepresentative with the PPN please consult the PPN Handbook, the chapter on PPN Representatives is accesible through the link below. Simply copy and paste the link into your browser.

https://acrobat.adobe.com/link/track?uri=urn:aaid:scds:US:d74cd64e-17e9-4453-8726-3709565ceca1

For more information on Leitrim Development Company, please copy and paste the link below into your browser.

http://www.ldco.ie/

Please read the Code of Conduct below. The Code of Conduct must be read and agreed to by all Representatives.

https://drive.google.com/file/d/1xajTSOGnrvULX2N2IiEYEUr-EIa4fcB7/view?usp=sharing

Apply now

On the next page, you can fill out your details to submit a nomination.

Page 2: Submission Form
Name of Nominee*

First NameLast Name
Organisation name *
Organisation's PPN number*
Community and VoluntaryEnvironmentSocial InclusionI don't know
BallinamoreCarrick-On-ShannonManorhamiltonNone of the above
Contact Details of Nominee
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Candidate Statement (Up to 150 words). This will be circulated to Leitrim PPN members ahead of an election. State why this Nominee may be the most suitable candidate for the role. *
I have read the Code of Conduct and will sign up to fulfil this if elected.*

Page 3: Authorisation from Organisation of Nominee (Authorised Officer)
This nomination must be authorised by the nominee’s organisation. The Authorised Officer is the organisation’s Chairperson. If the Chairperson and Nominee is the same person, this nomination needs to be authorised by a different office holder.
Name *

First NameLast Name
Position
Email*
example@example.com
Mobile Number
Please enter a valid phone number.Format: 000 000 0000.
Signature*

Nomination Form for Leitrim PPN Members to be Elected onto the Board of Leitrim Development Company

Page1: Eligibility Details

Page 2: Submission Form

Contact Details of Nominee

Page 3: Authorisation from Organisation of Nominee (Authorised Officer)

This nomination must be authorised by the nominee’s organisation. The Authorised Officer is the organisation’s Chairperson. If the Chairperson and Nominee is the same person, this nomination needs to be authorised by a different office holder.

Page 4: Confirmation and Declaration

Thank you for filling in this nomination form. Incomplete forms will be deemed invalid.