This nomination form is for the VCSE Sector System Leadership Group. It requests the nominee's name, organization, and contact details. The nominee must provide a 500-word statement explaining why they wish to be part of the group and what knowledge and expertise they will bring. The nominee and an authorized representative from their nominating organization must both sign the form declaring the information is true and the nominee is prepared to serve. The nominating organization must be a VCSE organization based in Norfolk. Completed forms must be returned by July 3rd to be included in the election.

1. Nomination Form
VCSE Sector System Leadership Group
Nominee Name
Organisation (if appropriate)
Contact Details
These will not be made publicly available
Address
Phone Email
Nominee Statement
Please provide a brief statement as to why you wish to be part of the VCSE Sector System Leadership
Group and what knowledge and expertise you feel you will bring.
This will be distributed ahead of the election. The statement is limited to 500 words. When we distribute
these summaries they will be truncated to the first 500 words.

2. Nominee Declaration
I certify the following. That I am willing to stand to be part of the VCSE sector system leadership group.
The information I have provided above is true to the best of my knowledge. I have read and understood
the paper outlining the role of the group and of those appointed to the group. I am prepared to work as
part of the system leadership group to the best of my ability for the benefit of the VCSE sector and
Norfolk as a whole.
Name…………………………………… Signature ……………………………………………
Date……………………………….
Nominating Organisation
Any individual may stand as a candidate but they must be nominated by a VCSE organisation
predominantly based in Norfolk. This means an organisation that has its registered office or main base
in Norfolk or delivers more than 50% of its services in Norfolk. A VCSE organisation for these purposes
is any registered or unregistered charity, any community interest company, any IPS or similar registered
society fulfilling the ‘societies for the benefit of the community’ definition, community associations that
have a governing document containing a clear public benefit purpose operating on a non-profit basis.
Name of Nominating
Organisation
Charity
Number (if
appropriate)
Company
Number (if
appropriate)
Organisation Address
Authorised Signatory
I certify the following. To the best of my knowledge the organisation named above meets the
requirements to nominate a candidate to the VCSE system leadership group. That I am authorised to
sign and submit this document on behalf of the above named organisation. That it is the organisation’s
intention to nominate the above named individual to be elected onto the VCSE sector system
leadership group.
Name…………………………………… Signature ……………………………………………
Date……………………………….
All nomination forms must reach Community Action Norfolk offices on the 3rd July by 1200 to be included
in the election.

3. Please return to Community Action Norfolk, Ambassador Way, Greens Road Dereham, Norfolk
NR203TL or by email to office@communityactionnorfolk.org.uk