Information marked with an asterisk "*" is required.
1. Personal details
2. Educational and professional background
3. Governance experience
4. Referees
Please nominate up to 3 professional, governance or personal referees.
Referee 1
Referee 2
Referee 3
5. Declaration

I understand that, by indicating a wish to be considered for appointment Victoria University Council or Committee, I will be asked to authorise a police criminal history check and may be subject to other checks required of potential appointees to State boards and authorities. I acknowledge that:

  1. Employees and students of VU are not eligible for appointed members of VU Council
  2. A person is not eligible for appointment to the VU Council if they are of unsound mind, or bankrupt, or have been convicted of any indictable offence.
  3. Appointed members are required to complete at least an annual Application for Determination of Fit and Proper Person form and abide by all relevant University policies e.g. Conflict of Interest and Council Code of Conduct.
  4. The information provided by me will be held by the University’s Secretariat in accordance with relevant privacy legislations and policies.
  5. VU may approach any person or body listed on this form for the purposes of verifying any nominee information given in this EOI.
  6. I will be expected to attend an induction session and sign a declaration confirming I have been inducted and understand by duties and responsibilities, and ongoing Council reviews.
  7. I hereby declare that I am a fit and proper person to be a member of the VU Council or a Committee and that I acknowledge that the information contained in this form is true and complete.

CV/résumé

After submission of this form, you will be prompted to email your CV/résumé to [email protected].