Application for Governance Committee (Licensee)

There is a position available on the governance committee, a representative representing a licensee contributing licence fees less than $3,000 per year. Previous members have come from the Fitness industry and small businesses (retail and doctors’ surgery) and have found the Committee experience to provide growth and a wealth of networking opportunity.

This is a volunteer position and most meetings are virtual. Where there is travel or other expenses, these are reimbursed in full. All personal data is collected in accordance with the Resolution Pathways Privacy Policy

Question Title

* 1. Your Contact Information

First Name

Last Name

Preferred contact number(s)

Email Address

Question Title

* 2. What State/Territory are you based in?

Question Title

* 3. What is your current employment & position?

Question Title

* 4. Please list any relevant membership organisations/affiliations (e.g. AHA, LPA, etc)

Question Title

* 5. Please provide a short summary of your experience with music licensing (a short outline of the relevant experience and dates). (You may be a music customer or produce an event featuring or using music, or have other knowledge of music licensing)

Question Title

* 6. Please provide referee's details

Name

Contact number

Basis on which you have worked with the referee

Additional details

Question Title

* 7. Please select which applies to you

You (your organisation) pays licence fees in excess of $3,000 per annum

You (your organisation) pays licence fees less than $3,000 per annum

Question Title

* 8. Stakeholder categories that you represent (please provide details in relevant categories only)

Hospitality

Retail

Media/Broadcaster

Education

Dance/Fitness

Events/Cinema

Digital Service Provider

Other

Question Title

* 9. List any experiences with Boards or Committees

Question Title

* 10. Specialist skills or training which might be useful in a sub-committee working on the dispute resolution system (please provide details where appropriate)

Question Title

* 11. Any other relevant information you’d like to share

Question Title

* 12. Confirmation of permission:
I have applied for a position on the governance committee. The information provided above is accurate. I consent to this data being shared with the selection committee and allow the dispute Resolution Facilitator or her nominee to contact my referees for the purpose of selection to this committee.

Agree

Disagree