Expression of Interest
KWT Board Member
Expressions of Interest have now closed. We are hoping to appoint new members shortly after. If you are interested in future board positions, please email our current board chair with your EOI. email@example.com.
I hereby declare that:
I do not have any conflicts of interest that may affect or appear to affect my directors duties, i.e. employment, directorships, partnerships, assets or liabilities.
I am not currently affected by bankruptcy action. (For the purposes of this question, a person is affected by bankruptcy action if the person - (a) is bankrupt; or (b) has compounded with creditors; or (c) as a debtor, has otherwise taken, or applied to take, advantage of any law about bankruptcy.)
I do not have any disclosable criminal convictions, i.e. convictions as an adult that form part of my criminal history (If you are unsure about the status of any criminal convictions which you have, you may wish to seek legal advice in responding to this question).
I am not aware of any charges pending against me or any matters involving offences which are under investigation and which may involve me.
I have not ever been the subject of a complaint to a professional body in Australia which has been substantiated or is currently under investigation.
Neither I nor my company is listed on the Register of Lobbyists.
I do not know of any reason why I should not be appointed.
I consent to provide the above information in respect of myself and understand that there is no legal obligation for me to do so. I declare that the personal information provided by me in this form is complete and correct to the best of my knowledge. I understand that I may be asked to consent to a criminal history check being undertaken in respect of myself and that the results of that check may be taken into account when assessing my suitability for appointment.
Privacy Collection Notice
Your personal information is being collected through this form for the purpose of selecting successful applicants to constitute the inaugural Board. Your personal information will not be shared with any other organisation outside of the Koondee Woonga-gat Toor-rong a subfund of the Australian Communities Foundation. If you do not provide the personal information requested by this form, the Advisory Board will be unable to consider your application for the Board. In completing this form, you consent to your personal information, including any sensitive information, being collected for the purpose described above.
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