Mentoring for Diversity

Mentee application form

Please read and complete all questions. See the Q&As for further details.

Eligibility

The following requirements must be met in order to be eligible to apply for the Mentoring for Diversity programme. Please confirm, by checking the boxes in the first column, that: (note double clicking on the box will enable you to check it)

Yes / Criteria
You are applying in relation to one or more of the following areas of diversity.
Gender
Ethnicity. Please state: ______
Age. Please state: ______
Skills and experience. This will be documented within your application form
Other. Please state: ______
You are or intend to become a member of the Institute of Directors in New Zealand.
You have the right to remain in New Zealand to work and study for a period of at least five years.
You have never been disqualified as a company director in New Zealand or overseas.
You are able to commit to the time and travel commitments of the Mentoring for Diversity programme. This means that:
  • you are able to be flexible with your time so that you can meet with your mentor regularly (who is likely to have a very busy schedule)
  • you have the time and availability to properly prepare for mentoring sessions and undertake any necessary work recommended by your mentor between sessions
  • you need to be New Zealand-based and are not planning to be out of New Zealand for any significant period of time during 2015 (more than two months in aggregate)
  • you are prepared to travel to Auckland three times at your own expense, once for the launch and mentee briefing on the afternoon and evening of24 June 2015, and for two mentee lunchtime events on 16 September 2015 and 17 February 2016.

You are currently actively seeking NZX or large company board appointments (ie it is not something that you are only looking to do in the future).
You are immediately able to accept additional board appointments (ie you are not too busy with existing board, executive or personal commitments).
You are not already a director on the board of two or more NZX or large companies.
You have not already participated on an IoD Mentoring for Diversity programme.
You have read and understood the guidelines for applicants on required skills and experience (see over page).

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Required skill and experience

Please read the following guidelines

The purpose of this programme is to provide assistance to board-readyapplicants who aspire to being appointed to the board of an NZX company or a large unlisted company. Board-ready indicates you will most likely have had experience on smaller or mid-sized boards, larger non-commercial boards or as an executive dealing with a board and now appear to be ready to take the step up to the board of an NZX or large company.

The intention of mentoring is not to be a broad training programme focused on upskilling general and technical skills, but rather about eligible candidates receiving guidance from chairmen who know what is required to be on a high performing board and who can give good advice on networking, positioning, conduct, presentation (personal and CV), etc.

The form of mentoring will vary from candidate to candidate, the style from mentor to mentor and is about enhancing eligibility for selection. It is not a guarantee of a board appointment as that process is dependent on demand not supply. Companies at this level look for board members with relevant specialist skills which should be supported by demonstrated “generic” skills and experience.

Applicants will be expected to demonstrate the following:

Technical and operational skill

At least 5 years experience:(tick any that apply)

Commercial –In senior management (senior executive or leadership team) of an entity of some significance in the commercial sector, the listed and unlisted space (large SME, family company, co-op, SOE, etc) or

Professional advisor –As a senior professional advisor to boards of entities of some significance (NZX or unlisted/public entity of equivalent size), eg lawyer, accountant, investment banker providing specialist knowledge/advice to the board, eg external and emerging markets, internationalisation, mergers and acquisitions and other legal issuesor

Public sector –In a senior position within government, public sector or not-for-profit sectors, that involves working closely with boards

and/or

Growing your own business – Demonstrated commercial expertise, eg achieving significant and demonstrable success in building and growing a company in a process that has necessitated the acquisition of a hands-on governance experience such as establishing and/or working with a board.

Other ______

Knowledge and understanding

A clear appreciation of the roles and responsibilities of the director under the Companies Act 1993, an excellent understanding of the value-adding role of the board as well as an appreciation of the distinction between governance and management.

Experience

At least threeyears experience of boardroom practice, preferably as a board member of an entity of some significance, or working closely with, and reporting to boards.

In what sector does your main experience with boards lie?

Large commercial entities

Small commercial entities

Public sector

Not-for-profit

Other ______

Financial literacy

Proven ability to understand the financial position of the company through interrogation of financial statements, etc.

General attributes

A well-developed critical faculty, independence of mind, ability to work in a team, confidence to ask questions, ability to evaluate own performance with a focus on continuous improvement, etc.

Applicants are encouraged to undertake rigorous self-appraisal before applying and consider their eligibility against the above, remembering that these are stated as a guide not a firm yardstick.

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SUMMARY INFORMATION

Contact details
First name: / Last name:
Email: / Contact phone no:
Address: / Postcode

Executive experience

You will be asked for more detailed information later in the form but as a summary, please fill in your most recent executive and board experience, along with the position and start/end date.

Organisation / Position and start/end date (eg CEO, 2005-2011)

Board experience

Organisation / Position and start/end date (eg Chair, 2006-2010)

Financial literacy

What evidence can you provide to demonstrate you have a sufficiently high level of financial literacy that would enable you to discharge your responsibilities as a member of anNZX or large company board?

Please indicate if you have completed any of the followingIoDDirector Development courses:

Company Directors’ CourseAudit and Risk Committees

Chairing the BoardBoards in Action

Finance Essentials

Governance Development Programme

Other ______

Education

Please list details of your most recent tertiary/professional qualifications.

Year completed / Institution name / Qualification (eg LLB, MBA)

Diversity

How in your view does diversity contribute to board performance? (300-400 words)

What can you bring to a board that will increase diversity of thought?(300-400 words)

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FULL SUPPORTING DETAIL

Executive experience

Please list your most recent executive experience(you can add up to four entries).

1 / 2 / 3 / 4
Position title
Organisation
Start date (year)
End date (or current)
Organisation type[1]
Number of FTE staff[2]
Annual operating revenue $m
Industry[3]
Briefly describe the organisation (max 20 words)
Briefly summarise your role and responsibilities (max 50 words)

Board experience

Please list your most recent board experience(you can add up to four entries).

1 / 2 / 3 / 4
Position title
Organisation
Start date (year)
End date (or current)
Organisation type[4]
Number of FTE staff[5]
Annual operating revenue $m
Industry[6]
Briefly describe the organisation (max 20 words)
Briefly summarise your role and responsibilities (max 50 words)

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If you are currently in full-time employment, please provide details of your ability to accept anNZXor large company board appointment(max 50 words). (Eg“My full time executive contract ceases on xyz date”, or “I have written approval from my employer to accept an NZX or largecompany board appointment provided it does not conflict”.)

Travel

Our preference will be to match mentees and mentors within the same region unless there is a reason why matching outside your region is more suitable. Please indicate your preference bearing in mind that if matched with a mentor outside your region, travel costs are the responsibility of the mentee.

I would prefer to be matched with a mentor within my region

I would prefer to be matched with a mentor based in (city)

If a mentor is not available in your region of choice, are you prepared to travel to meet with your mentor? (Please check box below).

Yes

No

If yes, which city would be most suitable? ______

Referees

Please provide details of two referees who can support your application and can verify your comments provided. (Note: your referees may be contacted).Please note: one referee must be the chair of a board on which you serve.

Referee 1(Must be the chair of a board on which you serve) / Referee 2
Referee name
Referee organisation
Relationship to you
Mobile or preferred contact number
Email

*Please confirm that you accept the Mentoring for Diversity programme terms and conditions by checking the box below.

Yes, I accept the terms and conditions.

Submitting your application

Please email your completed application form plus a copy of your current governance CV (max four pages) as word documentsto by 5pm on Tuesday 31 March 2015.

Please note that your CV may be provided to a number of mentors participating in the Mentoring for Diversity programme (see our Q&As for further details).

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Mentoring for Diversity

Terms and conditions

By submitting your application to the Mentoring for Diversity programme you agree and confirm each of the following:

  • the information provided in this application to the Institute of Directors in New Zealand (Inc) is true and accurate at the time of lodging
  • you understand and accept that you will be notified by the Institute of Directors as to the acceptance or rejection of this application by email no later than 12June 2015 and that no further discussion or review of your application will be entered into
  • you understand and accept the aims and limitations of the Mentoring for Diversity programme
  • you consent to the Institute of Directors contacting your nominated referees
  • you consent to the Institute of Directors publicly disclosing your full name and location if you are selected as a mentee in the Mentoring for Diversity programme
  • you consent to the Institute of Directors providing a copy of your application form (or extract from it) and/or CV to a number of mentors participating in the Mentoring for Diversity programme
  • you consent to the Institute of Directors providing a copy of your resume to chairmen and boards (on a case-by-case basis) who contact us looking for a director with your skills and experience with the aim of seeing whether you may be suitable for a board position
  • you consent to the Institute of Directors contacting you from time-to-time via email, telephone or mail in relation to the Mentoring for Diversity programme and in relation to any board vacancies which it becomes aware of and believes that you may be interested in
  • you agree to notify the Institute of Directors of any board positions you obtain as a result of the Mentoring for Diversity programme
  • all personal information collected by the Institute of Directors for the purpose of the Mentoring for Diversity programme is handled and may be disclosed in accordance with the Institute of Directors privacy policy
  • information collected by the Institute of Directors may also be used for marketing and survey purposes and you consent to the use of your personal information for these purposes. Any photos taken at the launch function or otherwise may be used for marketing of the Mentoring for Diversity programme.

If selected as a mentee in the Mentoring for Diversity programme:

  • you will attend a mentee briefing session on 24 June 2015 in Auckland at your own travel expense
  • you will attend two mentee lunchtime events on 16 September 2015 and 17 February 2016 also in Auckland at your own travel expense
  • you will provide feedback during the course of the programme in a timely manner, as requested from time to time
  • at all times, conduct yourself in a professional and ethical manner and refrain from any conduct that may harm your mentor
  • you will respect the confidentiality of the relationship by not disclosing the mentor’s name unless specifically agreed
  • you will keep confidential any information shared with you by your mentor and will not disclose any such information to anyone unless expressly authorised by your mentor
  • you will seek to avoid any conflicts between your interests and the interests of your mentor. If any actual conflict of interest or the potential for a conflict of interest arises, you will openly disclose that fact to your mentor and discuss how to deal with it in a manner which best serves your mentor’s interests
  • you will only use personal information supplied to you about your mentor (either by the Institute of Directors or your mentor) in a manner expressly authorised by your mentor.

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[1]Listed, unlisted, SOE, Crown Entity, Trust, IncSoc, Statutory Board, Co-operative, CCO, LATE, Tertiary Institute, Partnership

[2]Approximate number of employees

[3]eg mining, health, engineering, agriculture, forestry, insurance, health care, legal, etc

[4]Listed, unlisted, SOE, Crown Entity, Trust, IncSoc, Statutory Board, Co-operative, CCO, LATE, Tertiary Institute, Partnership

[5]Approximate number of employees

[6]eg mining, health, engineering, agriculture, forestry, insurance, health care, legal, etc