Board of Trustees Nomination Form

Current Candidate
Equal Opportunities
Further information
Confirmation
Complete

Please submit your nomination to be considered for election to the Board of Trustees.

* = mandatory fields to complete.

Nomination forms must be received no later than midnight on the 14th May 2025

If you have any questions or issues with your form please contact [email protected].

Please note: Successful candidates will be required to take part in an online induction programme and to attend and in-person Board meeting on the 26th - 27th September 2025

Preferred Pronoun

Title

First name

Surname

Previous forename and surname, if applicable

Address

Click here to enter your address manually.

Telephone

Occupation

Membership Number

Equal Opportunities

Date of birth

Date of birth: Day

Date of birth: Month

Date of birth: Year

Nationality

Ethnic Origin

Gender

Marital Status

Religious Belief

Disability

What kind of expertise do you consider you would bring to the Board?

Please select all that apply.

Governance

Research/Scientific

Healthcare

Legal

Transformational Change

Charity CEO

People and Culture

Clinical Service Delivery

What motivates you to apply to become a trustee of the MND Association?

Please tell us of any personal experience of MND you might have.

Maximum 100 words.

Please tell us of any personal experience of MND you might have.

Please be aware that your statement will be used as written* within the Voting Guide circulated to all members so remember to read through it carefully and check for any mistakes before you submit it.

Please keep to the designated word count (100 words per question) as any additional text will not be included.

*We reserve the right to withdraw/exclude candidate nominations where personal statements are considered defamatory or those that do not reflect the positive and inclusive values of the MND Association.

Tick to confirm

I confirm that I agree to be nominated. If elected I agree to sign and abide by the Code of Conduct for Trustees of the Motor Neurone Disease Association and to declare any potential Conflicts of Interest that could affect my role.

I confirm that I have never been disqualified as a trustee of an organisation or been declared bankrupt

If elected, I agree to a Disclosure and Barring Service (DBS) check.

Sign here

Sign above

Date

If you have any questions about your application form, please contact [email protected].

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Candidate

Equal Opportunities

Further information

Confirmation