AUSTRALIAN BUSINESS AND ASEAN

Scholarship application form

COMPANY DIRECTORS CONFERENCE DIRECTORSHIP:15

20 – 23 May 2015 Kuala Lumpur, Malaysia

Find out more w: beyond2020.com.au

The Company Directors Conference is Australia’s leading director event. It examines futuristic issues and trends; selected by directors, for directors.

A limited number of half fee scholarships (not including accommodation and travel costs) are being awarded to NFP and SME directors that do not have the financial means to attend the National Conference held from the 20 - 23 May 2015.

The scholarships are valued at AUD$1,840 (50 per cent of the early bird member price of AUD$3,680). The total amount payable for the successful applicant will be AUD$1,840 plus any additional travel and accommodation costs incurred.

Scholarship selection criteria

Applicants must be either:

• A director or executive of a charitable NFP organisation

• A director or executive of an SME or a business owner

Further criteria require applicants to be:

• Members of the Australian Institute of Company Directors

• Australian citizens

• Not currently a director or executive of a large listed company

• Able to demonstrate and explain why financial circumstances may otherwise preclude their attendance at the conference

• Able to demonstrate why they should be considered for a scholarship

• Willing to participate in social media/blog/video on their experience during the conference

• Agree to the terms of this application as set out by the privacy and application terms and conditions as outlined on page six of this document

• Applicant must not have previously been awarded with a National Conference scholarship

Having met the above criteria, the Conference Selection Committee will also take into consideration candidates:

• Living in rural and regional locations; or

• Who are Aboriginal or Torres Strait Islander; or

• With linguistically or culturally diverse backgrounds; or

• Who have a disability

The Conference Selection Committee will also take into consideration an individual’s reasons for applying for the scholarship and career aspirations.

Scholarship application

Applicants must complete the attached scholarship application and send it to us by 5.00pm Friday 30 January 2015. Late entries will not be considered.

Applications should be sent by mail or email to:

Jess Murray Australian Institute of Company Directors Level 30, 20 Bond Street, Sydney NSW 2000 Australia

or

jmurray@companydirectors.com.au

All applications will be acknowledged by the Australian Institute of Company Directors when they are received.

Notification of your acceptance or rejection of this application will be made by email by 5.00pm Monday 16 February 2015. The decision is final and no further discussion or review will be entered into. Successful applicants must register and pay the final balance of their conference registration at the time of enrolment.

Personal details

Name

Current position [Insert the position most relevant to your scholarship application if you have more than one directorship]

Telephone

Email

Postal address

Practical experience

Details of any board experience [With respect to each directorship — please include the year(s) that the directorship position was held; the type of directorship — executive/non-executive; the name of the company; details of any board experience in a charitable not-for-profit or small business and an indication of the size of the company’s operations — eg. 1999 - 2003, Non-Executive Director of XYZ, Not-for-Profit supporting xxxx stakeholders/revenue of xxx]

Details of any experience as a senior executive (reporting to an executive director/board)

[Please briefly describe your experience including the name of the organisation, your position, who you reported to, your responsibilities, period of time you held the position etc]

Details of any experience as business owner

[Please briefly describe your experience including your years with the company, position and highlights]

Selection criteria and relevant information

Reasons for Application Why have you applied for this scholarship?

[Please comment on why you have applied and believe you should be considered for this scholarship including financial circumstances which may preclude your attendance at the Company Directors Conference]

Contributing to your organisation, the economy and society

Why would you like to attend this conference?

[Please comment on how attending the conference would help you enhance your skills as a director, make a more valuable contribution to the governance of your organisation and/or have a lasting, positive impact to a sector of the economy/society]

Contributing to group discussion and use of social media/blog/video to share your experience during the conference

Comment on how you would seek to add value to group discussions in the lead up, during and after the conference.

Directorship career aspirations Comment on what you hope to achieve long-term in your directorship career.

Business Network Membership [Insert details of groups that you are a member of eg Australian Institute of Company Directors, Australian Chamber of Commerce, Indian business networks etc]

Confirm your time commitment

[Please tick]

I commit to attend the conference in full

Confirm your willingness to be profiled

[Please tick]

I agree to participate in social media discussions regarding the conference, and to be profiled in Company Director magazine after the conference, and/or provide a testimonial for other marketing collateral (eg website), and/or speak at the relevant business networking group where I am a member

Interests [eg. some of your interests/hobbies which you may discuss socially with other directors]

Testimonial contact

Name and contact details for referee

[Please include the name and contact details of the person who has supported your application and comments above]

Name:

Email:

Phone:

I have read, understood and agree to the cancellation policy, privacy consent and the other terms on this form.

Signed: Date:

Privacy and Application Terms and ConditionsAll applicants for the National Conference Scholarship are required to agree to the following terms and conditions:

• The information you will provide in this application to the Australian Institute of Company Directors is true and accurate at the time of lodging; and

• You have not currently or previously been disqualified as a company director; and

• You are an Australian citizen; and

• You are able to attend the conference from the 20 - 23 May in Kuala Lumpur

• You understand that you will be notified by the Australian Institute of Company Directors as to the acceptance or rejection of this application by email by 5.00pm on Monday 16 February 2015. Decision is final, no further discussion or review of your application will be entered into; and

• You consent to the Australian Institute of Company Directors using the contact details you have provided for the purpose of assessing your application including contacting your nominated referee; and

• If your application for the National Conference Scholarship Program is successful you consent to:

- the publication of your full name and State or Territory in the Australian Institute of Company Directors promotional material relating to the Conference Scholarship Program; and

- the use of your contact details on this form for the purposes of;

(a) The Australian Institute of Company Directors contacting you to award the National Conference Scholarship to you and manage it; and

• If your application for the National Conference Scholarship program is successful you agree to register for the conference and pay the final balance of 50% (AUD$1,840) at the time of enrolment and pay for any additional travel and accommodation costs that are incurred by you during your trip.

• If your application for the National Conference Scholarship Program is successful you consent and agree to participate in social media/blog/video on your experience during the conference and in a program evaluation survey; and

• The total value of the awarded scholarship is AUD$1,800 toward your Company Directors Conference Directorship:15 conference registration. The scholarship is valid for the Company Directors Conference Directorship:15 only and not transferable to future conferences, other event and courses or redeemable for cash.

• All personal information collected by the Australian Institute of Company Directors for the purpose of your application to participate in the National Conference Scholarship Program is handled and may be disclosed in accordance with these Terms and Conditions and the Privacy Act 1988 (Cth) and Australian Institute of Company Directors’ Privacy Policy and Privacy Consent. You agree to Australian Institute of Company Directors collecting and handling the information you provide in your application and otherwise for the purpose of processing your application to participate in the National Conference Scholarship Program and administering that program and in addition you have read and agree to your personal information being dealt with in accordance with Australian Institute of Company Directors’ Privacy Policy and Privacy Consent available on its website at w: companydirectors.com.au/General/Privacy-Policy

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