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BOARD OF THE STATE RECORDS AUTHORITY OF NSW
APPLICATION FORM Important informationThis form is to be completed by persons seeking nomination for appointment to the Board of the State Records Authority of NSW as:
Member representing local government; or Member representing the private sector.
Lodgement The deadline for applications is 5.00pm, Monday 4 January 2016. Please email your Application Form and a copy of your resume to [email protected]
Assessment processApplications will be assessed against the required capabilities and experience (see Section D below) by an Assessment Panel appointed by the Minister for Finance, Services and Property.
Interviews with shortlisted applicants (in person or by phone) will be scheduled for the week commencing 11 January 2016. Following interviews and referee checks, the Assessment Panel will submit a report on shortlisted applicants to the Minister. The Minister will then nominate selected applicants for appointment by the Governor.
A) APPLICATION TYPE
I wish to be considered for appointment as:
Member representing local government
Member representing the private sector
B) APPLICANT DETAILS
Name
Residential Address
Postal Address
Phone Mobile
Current Employer
C) APPLICANT RESUME
Please attach an up-to-date resume as a separate document. This should not exceed 5 pages. A cover letter or statement of intent is not required. However, you may include a cover letter provided it does not exceed 1 page.
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D) CAPABILITIES AND EXPERIENCE
You will be assessed against each of the criteria listed below. For each criterion, please provide a maximum of half a page of information which demonstrates your ability to meet the required capability.
1) Demonstrated experience in exercising sound judgement and ethical decision making, and understanding and managing conflicts of interest.
2) Well developed communication, liaison and negotiation skills.
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3) Relevant board and/or executive management experience.
4) Relevant experience and expertise in records management for local government or the private sector.
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E) APPLICANT REFEREES
Please insert the contact details of 2 relevant referees. The Assessment Panel may contact the referees if you are shortlisted for interview.
Referee 1Name
Organisation
Position
Phone
Mobile
Referee 2Name
Organisation
Position
Phone
Mobile
E) APPLICANT REFEREE REPORTSF). APPLICANT DECLARATION
I confirm the accuracy of the information provided in this application.
Signature of Applicant
Date
PRIVACY STATEMENT - The personal information you provide on this form is subject to the Privacy & Personal Information Protection Act 1998. It is being collected by NSW Department of Finance, Services and Innovation and will be used for purposes related to this application. NSW Department of Finance, Services and Innovation will not disclose your personal information to anybody else unless authorised by law. The provision of this information is voluntary. If you choose not to provide the requested information we may not be able to process this application. You have the right to request access to, and correct details of, your personal information held by the Department. Enquiries about privacy should be directed to Privacy Coordinator, Department of Finance, Services and Innovation, 2-24 Rawson Place, Sydney NSW 2000, Ph: (02) 9372 8720.
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