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* 1. Please provide your full name.

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* 3. What motivates you to apply for a Board member position at our women's residential rehabilitation service?

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* 4. In which of the following areas do you have experience? Select all that apply

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* 5. Have you previously served on a Board for a non-profit organisation or charity?

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* 6. If yes, how many years have you served on a Board for a non-profit organisation or charity?

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* 7. How many years experience do you have reporting to a Board yourself?

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* 8. If you answered 'Yes' to having previous Board experience, please describe your role and contributions.

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* 9. Are you familiar with the challenges facing women's AOD rehabilitation services?

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* 10. How do you believe your background or experience will benefit our organisation?

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* 11. Are you able to commit to monthly meetings held via Zoom? The current pattern of meetings is the third Tuesday of the month from 4:30pm-6pm.

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* 12. How well do you rate your knowledge and capability of the duties and responsibilities of a Board member, ie:
Understand the duties and responsibilities of Board members, the role of regulatory authorities, appreciate the potential personal liability and rights of Board members, and identify criteria for measuring achievements in not for profit organisations.

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* 13. How well do you rate your knowledge and capability of strategy and risk, ie:
Ability to determine the vision, purpose and values of an organisation, understand of the drivers of the business, ability to adopt and participate in an agile approach to strategy.

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* 14. How well do you rate your knowledge and capability of the finance and accounting aspects of an organisation, ie:
Ability to read and comprehend the organisation's accounts, financial materials, financial reporting requirements, and an understanding of the budgeting process.

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* 15. How well do you rate your knowledge and capability of governance practice, ie:
Understanding of the machinations of Board structures, meetings, subcommittees and other Board operations.

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* 16. Briefly list any governance training and/or certifications completed, or memberships held.

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* 17. On the scale below, how well do you rate your knowledge and capability of the following:

  Highly skilled Skilled Limited skill / experience
Policy development
Quality improvement and accreditation
Human resources and change management
Information and communications technology (ICT)
Marketing, media and communications
Fundraising and grant writing
Contract management
Business development

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* 18. Briefly list any relevant professional, technical and/or tertiary training completed or memberships held

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* 19. Sector Experience: Briefly describe any experience you have in the alcohol and other drug sector.

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* 20. Briefly describe any experience you have with serving vulnerable client groups.

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* 21. Do you have any lived experience of alcohol or other drug dependence? This can either be personal lived experience, or the experience of supporting someone else.

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* 22. In which age range do you fall?

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* 23. How would you describe your gender?

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* 24. The following information will assist in our goal of building a safe, supportive and culturally appropriate organisation.

  Yes, Aboriginal Yes, Torres Strait Islander Yes, both Aboriginal and Torres Strait Islander No
Do you identify as an Aboriginal and/or Torres Strait Islander person?

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* 25. Commitment:
How much time are you willing and able to contribute to the Kamira Board should you be appointed?

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* 26. Which subcommittee, or in which area of special interest, are you willing to serve?

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