board of directors nominee form - gisborne.ponyclubvic.org.au€¦  · web viewpony club australia...

PONY CLUB Australia Ltd

73-75 Mackie Road, Mulgrave 3170National Chair: Carol Paterson P: 03 8685 8925 | E: info@ponyclubvic.org.auM: 0428 531 359 | P: 07 4653 1359 ABN: 95 090 080 265 National Secretary: Judy Pitt www.ponyclubaustralia.com.auM: 0428 593 591 | P: 03 6396 6191 Patron: Gillian Rolton

Nominations close: 1st May 2015

PCA Board Nomination FormNominee Information

Full name: ...................................................................................................................................

Postal address: ...........................................................................................................................

Phone(h): ......................................................... Phone(w): ......................................................

Email: ..........................................................................................................................................

Nominee DeclarationI understand that if I am elected to the PCA Board I will need to relinquish any position as; an employee of PCA, a Member State, Affiliated or Corporate Member or any Official Position with a Member State and that I am not a Director of PCA where clause 13.5.2 applies.

Signature: .............................................................................................. Date: ........................

Nominee Ratification

Full name: ...................................................................................................................................

State: ................................................................ Position held: ................................................

Signature: .............................................................................................. Date: ........................

Please ensure you complete the Nominee Experience & KnowledgeThank you for your nomination

Nominees should be aware that they should be present at the AGM so if elected they can take their place on the board immediately.

PONY CLUB Australia Ltd

Nominee skills and experience

Full name: ...................................................................................................................................

Please tick any of the following skills or experience that you may possess:☐ Finance, accounting ☐ Management, administration

☐ Grant writing ☐ Nonprofit experience

☐ Fundraising and event management ☐ Legal

☐ Public relations, communications

Why are you interested in joining the Pony Club Australia Board?

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Pony Club experience, knowledge and current positions:

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Professional experience, current position and education:

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Previous board experience (if any):

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Affiliations or organisations the candidate belongs to (e.g., membership, professional).

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Please attach a passport size photograph (jpeg) and 250 word (word doc. format) statement about yourself and your experience to be included in voting information. All applications should be emailed to info@ponyclubaustralia.com.au and marked as Board Nomination.