Board Nomination Form

Thank you for your interest in joining the Board of the Youth Coalition of the ACT.

This form helps us get to know prospective nominees so that we can assess suitability and, where appropriate, support your nomination for election.

Before you begin, we recommend reading the position description to learn more about the role and responsibilities: Board Director Position Description

After you submit your nomination, a current Youth Coalition Board member will contact you to arrange a short, informal chat. This conversation is a chance for you to learn more about the role. It's designed to be supportive and to help you feel confident about the nomination process.

Name *

First

Last

Email address *

Contact number *

Are you a current financial member of the Youth Coalition? *

Yes
No
Unsure

If you are not currently a member, you will also need to complete a membership application. Please finish this board nomination form first, then visit youthcoalition.net/membership-application to apply for membership.

If you're unsure whether you're a financial member, please complete this form and then contact us at office@youthcoalition.net or phone (02) 6247 3540 to check your membership status.

Save and Resume Later

Eligibility Questionnaire

Do you have, or are you willing to get, a Working with Vulnerable People’s check? *

Have you ever been disqualified from acting as a director, trustee or “Responsible Person” of a company, incorporated association, charity or nonprofit (either by law, by a Court order, or by a regulator such as ASIC or ACNC)?

or your Coalition,

If yes, please describe the nature of the disqualification, when it occurred, whether it has been resolved, and any restrictions still in place. *

Are you (or have you been) subject to bankruptcy or other insolvency proceedings that might affect your capacity to serve?

Are you (or have you been) subject to bankruptcy or other insolvency proceedings that might affect your capacity to serve? *

Have you ever been removed from, resigned from under pressure, or had a position terminated on a board or governing body? If yes, please describe the circumstances.

Have you ever been removed from, resigned from under pressure, or had a position terminated on a board or governing body? If yes, please describe the circumstances. *

If yes, please describe the circumstances *

Do you have any existing relationships (commercial, personal, financial or otherwise) that might give rise to a real or perceived conflict of interest in serving as a board member?

Do you have any existing relationships (commercial, personal, financial or otherwise) that might give rise to a real or perceived conflict of interest in serving as a board member? *

If yes, please describe *

If elected, are you willing to abide by the Conflict of Interest policy of the Youth Coalition, including recusing yourself from any decision where you are conflicted?

If elected, are you willing to abide by the Conflict of Interest policy of the Youth Coalition, including recusing yourself from any decision where you are conflicted? *

Are you able to commit to the expected 10hrs/month for board meetings, committee work, events, etc.?

Are you able to commit to the expected 10hrs/month for board meetings, committee work, events, etc.? *

Save and Resume Later

Endorsers

If you already have two endorsers, please provide their names below.

If you don’t have endorsers, don’t worry! Youth Co can arrange these if you are found suitable for endorsement.

Endorser Name 1

Endorser Name 2

Save and Resume Later

Candidate Bio

Please provide a brief bio (maximum 250 words) introducing yourself to the membership.
You may wish to include:

A short overview of your work, volunteer, or board experience
Key skills or expertise you would bring to the Board
Your motivation for nominating and what you hope to contribute

Brief bio introducing yourself (250 words max) *

Save and Resume Later

Supporting Documents

Please upload your CV (PDF preferred)

Drag & Drop Files, Choose Files to Upload

Declaration

By submitting this form, I confirm that the information provided is true and accurate to the best of my knowledge, and I consent to the Youth Coalition contacting me regarding this nomination.

Signature

Clear Signature

Date

Board Nomination Form

Eligibility Questionnaire

Endorsers

Candidate Bio

Supporting Documents

About

What We Do

What's On

News & Resources

Subscribe