ࡱ>  bjbj 6L  tt8PLt;&&&&E"E"E"2:4:4:4:4:4:4:$-=?X:# >E"##X:tt&&m:L}%}%}%#Lt&&2:}%#2:}%}%4Lf9& [a#f8::;z8g@[$g@(f9g@f9E""g"}%""E"E"E"X:X:$E"E"E";####g@E"E"E"E"E"E"E"E"E" ::   BLAENAU GWENT COUNTY BOROUGH COUNCIL LOCAL AUTHORITY GOVERNOR APPLICATION FORM It is essential that you complete this form fully and sign. In particular please can you list your skills and how they can support and challenge the governing body. This information will enable the panel to make an informed decision about your application.  School(s) at which you wish to become a LA Governor  Would you consider being a LA governor at other BGCBC Schools  If you are already a Governor, please give the following information  Are you elected member of BGCBC (if yes please state ward)  Please outline your experience of other work with schools or in educational settings. (e.g. volunteer helper, member of PTA.) or elsewhere which may be relevant to you being a governor.)  Please set out below why you would like to become a governor, and any particular areas in which you feel you would be able to contribute to the work of the governing body (e.g. Finance, HR, data analysis experience):  What is your interest in/knowledge of the school?  Please complete and sign the following declaration: (please delete as appropriate) I would like my application to become a LA Governor to be considered I am willing for the information on my governorship to be made available to interested parties in relation to the purposes outlined below. I certify that I have read Appendix A and will abide by the appointment criteria and am not disqualified from becoming a governor as per the criteria. I agree to inform the Clerk to Governors, in writing, immediately should I cease to be qualified to serve as a governor. I am an employed member of staff of BGCBC and confirm that I have sought approval from my line manager that my application to become an LA appointed school governor does not present a conflict of interest in fulfilling my paid role. Signed: Date:  Please return this form to: Governor Support, Education Achievement Service, Tredomen House, Tredomen Park, Ystrad Mynach, Hengoed, CF82 7PG. Email:  HYPERLINK "mailto:governor.support@sewaleseas.org.uk" governor.support@sewaleseas.org.uk (If you have any queries relating to the completion of the form please phone 01443 863242) THIS FORM IS AVAILABLE IN WELSH ON REQUEST For office use Application accepted/ accepted with conditions/ rejected (delete as appropriate) Narrative for accepted with conditions:- Signed :- Date:  Appendix A LOCAL AUTHORITY GOVERNOR APPOINTMENT/ELIGIBILITY CRITERIA LA governors are representatives of the ýapp and not delegates. This means that they cannot be directed by BGCBC to act in a certain way but they should represent the views of the BGCBC. A LA governor is expected to help the school improve and support the schools ethos and mission. A LA governor is expected to provide the school with the skills and experience that it needs. All LA governors are expected to abide by the Governors Code of Conduct A LA governor is expected to possess the following attributes: An ability to respect confidentiality.An interest in education.Communication skills.An ability to absorb information.Tact and diplomacy.An ability to work as part of a team.A willingness to give your time.A commitment to equal opportunities.An open mind.A willingness to undertake training. All appointments will for a 4 year term. LA governors will be required to attend the mandatory training for school governors. You are unable to be appointed as a governor if you: are under 18 years of age; are already a governor of the school (i.e., you are not trying to hold two governor positions but you may change category, or be reappointed); are detained under the Mental Health Act 1983; are a bankrupt or subject to a disqualification order under the Company Directors Disqualification Act 1986 or to an order made under section 429(2)(b) of the Insolvency Act 1986; have been removed from a charity trusteeship by the Charity Commissioners or High Court on the grounds of misconduct or mismanagement; are included in the list of teachers or workers prohibited or restricted from working with children or young persons under List 99 or the Protection of Children Act; have in the previous five years (or since becoming a governor) been sentenced to three months or more in prison (whether this was suspended or not) without the option of a fine before becoming a governor or since being a governor; have in the previous twenty years, received a prison sentence for two and a half years or more; have at any time received a prison sentence for five years or more; have been fined for causing a nuisance or disturbance on school premises during the five years prior to, or since, appointment or election as a governor. act as the clerk to governors of the school at which you wish to become a governor. are eligible to be a Staff or Teacher Governor at the school. Have been disqualified from the governing body in the past 12 months.     Title: Surname: Forenames: Address: Postcode: Tel. Home: Tel. 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[ @Verdana?= *Cx Courier New;WingdingsA$BCambria Math"hq'q'M   $  $!820 KqKX  $P*s2!xx  APPENDIX A IT ServicesMichelle Jones - Education(       Oh+'0`    ( 4@HPX APPENDIX A IT ServicesNormalMichelle Jones - Education2Microsoft Office Word@F#@z@sQ@sQ ՜.+,D՜.+,D hp  Caerphilly CBC$   APPENDIX A Title 8@ _PID_HLINKSAL}*mailto:governor.support@sewaleseas.org.uk  !"#$%&()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~     Root Entry FE[Data ' k1Table@WordDocument6LSummaryInformation(DocumentSummaryInformation8CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q