Secretary Trustee Appication

LCGB Secretary Trustee Application Form

Please fill out the below application, alternatively please scroll to the bottom of the page and click the button to download a 'paper' copy to email in. If you would like assistance in completing this form please contact info@lcgb.org Applications accepted up until 5pm, Monday 20th June 2022

Date(Required)

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City County Post Code Country

Email(Required)

Phone

Social media presence(Required)

Are you currently certified as an IBCLC?(Required)

Yes

Retired

When did you retire from your IBCLC qualification?(Required)

Do you intend to sit the IBCLC Exam?(Required)

Yes

When do you intened to sit the IBCLC exam?(Required)

Please list any additional professional qualifications you hold(Required)

Please describe your experience in administrative/secretarial roles(Required)

300 words max

Please describe your experience in other advocacy groups – voluntary or professional(Required)

300 words max

Briefly describe your current work, any clinical practice and your workplace setting for each role.(Required)

300 words max

Give examples of how you would ensure EDI is a focus within your work as a trustee? Draw on your personal and professional experience and interests.(Required)

300 words max

Governance responsibilities and board roles.

Briefly describe any additional skills, experience, previous charity or board work, or additional credentials that support working as a trustee at a strategic level with governance responsibility.(Required)

300 words max

Briefly describe what you could offer LCGB as a trustee.(Required)

300 words max

What motivates you to become a trustee?(Required)

300 words max

Please include details of two referees stating their relationship to you and how long they have known you. Referees will only be contacted if you are offered the role.

Name

First Last

Referee #1

Phone

Referee #1

Date known since

Approximately Referee #1

Name

First Last

Referee #2

Phone

Referee #2

Date known since

Approximately Referee #2

Please fill out the above application, alternatively please click the button to download a 'paper' copy to send in.

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