Cancer Black Care Trustee Application Form

Cancer Black Care Trustee Application Form

Cancer Black Care Trustee Application Form

Please complete all required fields below
Name*

First NameLast Name
Date of Birth*

DayMonthYear
Date
Email*
example@example.com
Phone Number*
Address*

Street Address

Street Address Line 2

CityCounty

Postal / Zip Code
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About the Role

In this section we’d love to know more about you and why you'd like to apply for the role of a Trustee.
What motivates you to apply to become a Trustee of Cancer Black Care? *
Which aspects of our work and mission resonate most strongly with you, and why?*
What knowledge, experience, or perspectives do you feel you can contribute to the Board?*
As a Trustee, what impact would you like to help Cancer Black Care achieve in the future?*
How do you see yourself contributing as an active and engaged member of our Board?*
What strengths do you bring to group discussions and decision-making?*
What helps you feel confident and effective when working as part of a team?*
YesNo
If yes, please provide details.*
How do you think you can contribute to the growth and development of the charity?*
Which skills, knowledge, or expertise do you feel you can bring to Cancer Black Care (e.g. finance, legal, health, fundraising, HR, strategy, lived experience)?*
Personal Statement*
Please use the space below to write a short statement supporting your application. Please include details of any skills or qualities you could bring to the role, and some details of your professional or personal background would be useful.
Please upload a copy of your CV here

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References

Please supply the names, telephone numbers and email addresses of two references, whom we may contact as part of the appointment process.
Reference 1
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: 0000 000 0000.
Reference 2
Name*

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

Disclosure and Barring Services (DBS)

As we work with vulnerable service users most posts will require you to undertake an enhanced DBS disclosure. If you are aware of any convictions, cautions, reprimands or warnings which might appear on an enhanced disclosure please detail below.Our power to require this lies in the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 which removes the normal operation of the Act in relation to specific occupations, including the provision of home care services. In the event of being employed in connection with this application, any failure to disclose such convictions could result in dismissal or disciplinary action. The amendments to the Exceptions Order 1975 (2013) provide that certain spent convictions and cautions are ‘protected’ and are not subject to disclosure to employers, and cannot be taken into account. Guidance on criteria on the filtering of these cautions and convictions can be found on the Disclosure and Barring Service website.)
Persons disqualified from being trustees of a Charity (at July 2006)

·      Anyone who has been convicted of an offence involving deception or dishonesty, unless the conviction is spent;

·      Anyone who is an undischarged bankrupt;

·      Anyone who has previously been removed from trusteeship of a charity by the Court or the Commissioners for misconduct or mismanagement;

·      Anyone who is under a disqualification order under the Company Directors Disqualification Act 1986.

It is normally an offence to act either as a charity Trustee or as a nominee while disqualified unless the Charity Commission has given a waiver under section 72(4) of the 1993 Act.
Correct
Correct
YesNo
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