CHA Board Member Application FormPlease enable JavaScript in your browser to complete this form.Name *Address *Address Line 1Address Line 2CityState / Province / RegionPostal CodeMobile Telephone No *Telephone NoEmail *EmailConfirm EmailReasons for Applying and Experience1. Please tell us why you are interested in joining CHA’s Board of Management.2. What personal experience, skills and knowledge do you feel you can bring to the Board?3. What areas of our work are you particularly interested in?4. Are you (or have you been) involved in other voluntary work? If YES, please provide details below.Current Relationship to Cunninghame Housing Association5. Are you a Cunninghame Housing Association tenant, factored owner or member? If YES, please provide details below.6. Are you related to anyone who is already a member of CHA’s Board of Management or to someone who is employed by either Cunninghame Housing Association, Citrus Energy or Cunninghame Furniture Recycling Company? If YES, please provide details below.7. Are you involved with any business that provides services or is contracted to either Cunninghame Housing Association, Citrus Energy or Cunninghame Furniture Recycling Company? If YES, please provide details below.8. Are you employed? If YES, please provide details below.If your application to join the Board of Management is successful we ask that you become a share member of the Association which requires the completion of a share membership application form and payment of £1. If this causes any issues for you we may be able to co-opt you onto the Board of Management which would still allow you to join but you would not have the same rights and responsibilities as full members.DeclarationI confirm that I have read the Cunninghame Housing Association’s Board of Management Role Description, Person Specification and Eligibility Form and that I am eligible to become a Board of Management member.Name *by typing your name in this box you are agreeing to the above declaration.Date *Eligibility for the Board Extract from Cunninghame Housing Association Rulebook A person will not be eligible to be a Board Member and cannot be appointed or elected as such if:- 43.1.1 he/she is an undischarged bankrupt, has granted a trust deed which has not been discharged or is in a current Debt Payment Plan under the Debt Arrangement Scheme; or 43.1.2 he/she has been convicted of an offence involving dishonesty which is not spent by virtue of the Rehabilitation of Offenders Act 1974 or an offence under the Charities and Trustee Investment (Scotland) Act 2005; or 43.1.3 he/she is a party to any legal proceedings in any Court of Law by or against the Association; or 43.1.4 he/she is or will be unable to attend the Board Meetings for a period of 12 months; or 43.1.5 he/she has been removed from the Board of another registered social landlord within the previous five years; or 43.1.6 he/she has resigned from the Board in the previous five years in circumstances where the resignation was submitted after the date of his/her receipt of notice of a special Board meeting convened to consider a resolution for his/her removal from the Board in terms of Rule 44.5; or 43.1.7 he/she has been removed from the Board in terms of Rules 44.4 or 44.5 within the previous five years; or 43.1.8 he/she has been removed, disqualified or suspended from a position of management or control of a charity under the provisions of the Law Reform (Miscellaneous Provisions) (Scotland) Act 1990 or the Charities and Trustee Investment (Scotland) Act 2005; or 43.1.9 he/she has been removed from the office of charity trustee or trustee for a charity by an order made by the Charity Commissioners for England and Wales or by Her Majesty’s High Court of Justice in England on the grounds of any misconduct in the administration of the charity for which he/she were responsible or to which he/she were privy, or which his/her conduct contributed to or facilitated; or 43.1.10 a disqualification order or disqualification undertaking has been made against that person under the Company Directors Disqualification Act 1986 or the Company Directors Disqualification (Northern Ireland) Order 2002 (which relate to the power of a Court to prevent someone from being a director, liquidator or administrator of a company or a receiver or manager of company property or being involved in the promotion, formation or management of a company); or 43.1.11 his/her nomination for election to the Board has been rejected in accordance with Rule 40.3 during the period between the return of the completed nomination form and the commencement of the relevant Annual General Meeting. 43.1.12 he/she is the spouse, partner, child (including adopted child or step child), parent, parent-in-law, grandparent, grandchild or sibling of a Board Member or of a governing body member of any other organisation in the Group. 43.2 A person cannot be re-elected as a Board Member if the Board is not satisfied under Rule 37.6 of the individual’s continued effectiveness as a Board Member. In these circumstances the Board must not allow the individual to stand for re-election. I declare that the above information on this form is correct and understand that if appointed, I will be liable to action including removal from the Board of Management should I knowingly give false information. Name *by typing your name in this box you are agreeing to the above declaration.DateEquality Monitoring Form Information for those completing the form Why we are asking for equality information? We collect equality information to help us to plan and deliver effective services and to meet our legal and regulatory obligations. What do we do with equality information? We use equality information for a range of purposes, including to help us to: protect and promote your rights and interests promote equality objectives across our services identify and address our customers’ needs, and improve our services identify and eliminate any form of discrimination. Do you need to answer every question? By answering as many questions as possible you will help us meet your needs better, but we provide options throughout this form to allow you to provide only the information you want to give us. You can complete some questions and not others or you can complete parts of questions. The form has space for you to tell us more about your needs if you want. We may ask for some information in other forms where this is required by law. For example, where we need to know your age if you are applying for a home as only those over 16-years-old can be registered on our housing list. How do we process your equality information? We process equality information strictly in line with data protection law, including by: processing your equality data confidentially restricting access only to relevant staff members retaining equality information only as long as necessary sharing data only as lawfully permitted destroying data securely. Who do we gather equality information about? We gather equality information from: people who apply for a home tenants people who apply for a job with us our employees board and committee members Elected members (in case of local authorities) Other formats: We can provide this document in alternative formats if required. Equality Monitoring FormAge16-2425-3435-4445-5455-6565+Belief or religionPlease tick the box which best describes your belief or religion from the list below?BuddhismChristian CatholicChristian ProtestantHinduismIslamJudaismSikhismNo specific belief in religion (for example, atheism or agnosticism)OtherPrefer not to sayDisabilityAre you a disabled person? YesNoIf yes, please tick the box which category you would use from the following list:Autoimmune: (for example, multiple sclerosis, HIV, Crohn’s/ulcerative colitis)Learning difficulties: (for example, Down’s Syndrome)Mental health issue: (for example, depression, bi-polar)Neuro-divergent condition: (for example, autistic spectrum, Dyslexia, dyspraxia)Physical impairment: (for example, wheelchair-user, cerebral palsy)Sensory impairment: (hearing impairment)Sensory impairment: (visual impairment)Other: If none of the categories above apply to you, please specify the nature of your impairment.Prefer not to sayPlease specify the nature of your impairmentEthnicityPlease tick the box that best describes your particular group. AfricanAfrican, African Scottish or African British:Other African background (please specify):Other African background (please specify):please give detailsAsian, Scottish Asian or British Bangladeshi, Bangladeshi Scottish or Bangladeshi British:Indian, Indian Scottish or Indian British:Pakistani, Pakistani Scottish or Pakistani British:Chinese, Chinese Scottish or Chinese British:Other Asian background (please specify):Other Asian background (please specify):please give detailsBlack or CaribbeanCaribbean, Caribbean Scottish or Caribbean BritishBlack, Black Scottish or Black BritishOther Caribbean or Black background (please specify)Other Caribbean or Black background (please specify)please give detailsMixed groupsMixed or multiple ethnic group (please specify)Mixed or multiple ethnic group (please specify)please give detailsWhiteEnglishGypsy TravellerIrishPolishRomaScottishWelshOther BritishGenderWhat is your sex?FemaleMaleNon-BinaryIntersexGender ReassignmentPrefer not to saySubmit View Our Privacy Notice
