Application Form

Personal

Full Name: *

Address for Correspondence: *

Telephone number (daytime): *

Telephone number (evening): *

Mobile Number: *

Email: *

Experience and History

Briefly summarise relevant personal history and experience e.g. employment, volunteering experience and other relevant background information: *

How do you believe you could add value to The STAR Centre? *

What do you hope to gain from being a Trustee of The STAR Centre? *

Conflict of Interest

Are you related to any member of staff or serving Board Member? *

Yes No

If YES, please give details:

Are you aware of any possible conflict of interest which might arise either personally, in relation to your employment or in relation to your connections with any individuals (including family members) or organisations should you be appointed? *

Yes No

If YES, please give details: *

Declaration of Eligibility

I declare that:: *

I am aged 16 years or over at the date of this application. I am capable of managing and administering my own affairs. I do not have any unspent conviction relating to any offence involving deception or dishonesty. I am not an undischarged bankrupt nor have I made a composition or arrangement with, or granted trust deed for my creditors. I am not subject to a disqualification order under the Company Directors Disqualification Act 1986 or to an Order made under section 429(b) of the insolvency Act 1986. I have not been removed from the office of charity trustee for a charity by an OSCR or Court of Sessions on the grounds of any misconduct or mismanagement. I do not have a conflict of interest which would prevent me from becoming a director of The STAR Centre at this point. I am not disqualified under the PVG scheme.

Data Protection

Data Protection Act 1998: As part of the recruitment procedure we may collect and store sensitive personal data on you. We are required by law to obtain your consent to such data being recorded. It is our policy to store data relating to recruitment procedures for up to six months after the date on which it is submitted. Any information of this nature will be treated confidentially. Sensitive personal data is defined as information relating to any of the following; racial or ethnic origin, political op: *