Board Nomination Form

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Retirement
Village

F0RMS

Appointment to the Board of Free Reformed Retirement Village Association

Phone

Details of Nominee:

First Name *

Last Name *

Address *

Suburb *

State *

Post Code *

Email Address *

Contact Number *

Board Position Nominating For *

Essential Board Skills *

Accounting Law Consumer Representative Health & Aged Care Please select all that are relevant

Desirable Board Skills/Experience *

Financial Management Legal Issues Asset Management/Building Organisational Management Not-for-profit sector Health policy, planning & delivery Clinical Governance Online/Social Media Strategic Planning Other Please select all that are relevant

Relevant Experience

Consent Obtained *

I declare that I have obtained the Consent of the abovementioned person to nominate them for a position on the board of the Free Reformed Retirement Village Association Inc.

Date *

The following members of Free Reformed Retirement Village Association nominate and second the nominee listed above for appointment to the Board of Management of FRRVA:

Nominated by:

First Name

Last Name

Address *

Suburb *

State *

Post Code *

Declaration

I declare that the above information is true and correct

Date *

Seconded by:

First Name

Last Name

Address *

Suburb *

State *

Post Code *

Declaration

I declare that the above information is true and correct

Date *

Please also include the following documentation with this nomination form:

CV/resume *

Letter of character reference – to be provided by your elder or minister *

Completed Membership Application Form (if not already a member)

To download and print off a PDF version of this form click here

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Fair Haven Retirement Village
15 Pine Tree Close
ARMADALE WA 6112

(08) 9399 7173

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