Please note only information included in Section A and the personal statement will be made available publicly.
Other information will be used to register details with the Charity Commission and Companies House if the nominee is appointed to the board.
Section A is about the organisation making the nomination to the board.
Section B is for completion by the person being nominated.
Closing date for nominations 5pm on 15 January 2019.
Please click on the 'next page' button to complete the nomination form.