Transformation Nation Board Application Form

FOR OFFICE USEBoard

Ref# __________ Date______
Board Application Form
Thank you for your interest in Boarding with Transformation Nation, Inc. (T-Nation) The Board plays a vital role in helping us reach our mission to provide support to children who have been affected by trauma. All Board applications are reviewed with consideration of current Board opportunities. The information you provide will be stored in confidence under the provisions of the Data Protection Act. Your completed form will be held securely and confidentially. Only authorized staff will have access to your information.
Name
Name:

Mr.Mrs.Miss.Ms.
Postal Address
County
Telephone: (Home)
Format: (000) 000-0000.
(Mobile)
Format: (000) 000-0000.
E-Mail
example@example.com
Birthdate

MonthDayYear
Day / Month / Year
If you are involved with us as a Board and an emergency arises, whom should we contact?
Name
Relationship
Telephone: (Home)
Format: (000) 000-0000.
(Mobile)
Format: (000) 000-0000.
EQUAL OPPORTUNITIES

T-Nation is committed to equal opportunities and all Board recruitment decisions will be based on merit, suitability for the role and experience. All Board recruitment decisions will not be influenced by race, color, nationality, religion, sex, marital status, family status, sexual orientation, disability, age or membership of the Traveler Community. T-Nation fully endorses a working environment free from discrimination and harassment.
T-Nation is committed to standards of excellence in Child Protection practices. Where your Board role may have direct contact with children, you will be required to complete a Background Check Form, which will be processed by CJIS the Criminal Justice Information Services at a later date due to the National Pandemic and COVID-19 crisis. In the meantime, please complete the question below. Have you ever been convicted of an offence in the Republic of Ireland or elsewhere?

YesNo
If you checked yes, please provide details below
Your Skills and Interests FOR OFFICE USEBoard

Ref#__________ Date: _______
1.Have you ever done any voluntary work before?

YesNo
If you answered yes, please tell us a little about the experience.
2.Why do you want to Board now? What has motivated you to get in touch with us?
3.Do you have any particular skills or qualities that you could use in your voluntary work?
4.Are you applying for a specifically advertised position?

YesNo
If yes, please write the following: Role name Reference # (Leave Blank)
5.What kind of voluntary work interests you? (See ‘Categories of Boarding in Educate Together’ for more information)

Parents AssociationSchool Based ActivitiesProject Based BoardingInternship in the National OfficeOther
6.When are you available for voluntary work?

Totally FlexibleHave Specific Availability (Choose below)

Rows	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
Morning
Afternoon
Evening

7.How long do you intend to Board for? (note that some opportunities demand a minimum time commitment, ie. Board level roles)
8.Where do you wish to Board? (County / City Area or National Office / Local School)
9.How did you find out about Boarding with Transformation Nation?

Information / Outreach meetingEducate Together WebsiteLeaflet / PosterWord of MouthA Board CentreBoard matchMedia Radio / Television / Newspaper
References FOR OFFICE USEBoard

Ref#__________ Date: _______
1. Name
Relationship
Place of Work: (If applicable)
Position
Telephone: (Home)
Format: (000) 000-0000.
(Mobile)
Format: (000) 000-0000.
E-Mail
example@example.com
2. Name
Relationship
Place of Work: (If applicable)
Position
Telephone: (Home)
Format: (000) 000-0000.
(Mobile)
Format: (000) 000-0000.
E-Mail
example@example.com
If you have any queries when completing this application form, please phone 443-873-9106 or e-mail: info@mytransformationnation.org. If you would like to find out more about Transformation Nation’s Awardee Program, log onto our website Transformation Nation, Inc. for details.
Is there any additional information you would like to bring to our attention?
I declare that the information I have provided is true. All my actions as a Board will reflect the ethos of Transformation Nation, Inc. and I agree that being Child Centered will be central to my role.
Signature
Date

MonthDayYear
Date
For Office Use Only

NOtes
Board Position
Board Interview
Board Role Description sent
References Collected
Board Start Date

MonthDayYear
Date
Should be Empty:

FOR OFFICE USEBoard

Board Application Form

Your Skills and Interests FOR OFFICE USEBoard

References FOR OFFICE USEBoard

For Office Use Only