UKLA Trustee Registration Form

Title *

e.g. Doc, Prof, Ms

Full Name *

First

Last

Mobile Number *

Home Telephone Number/Landline *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Date of Birth *

National Insurance Number

Date of appointment to the EC *

Role on the EC *

Date of resignation

Names of connected people

Occupation

Employer

Directorships of companies

*Whether limited by share or guarantee

Governorship of educational institutions

Interests in other educational institutions

Interests in government departments

Interests in publicly-funded bodies

Trusteeship/directorship/advisership of other registered charities

Membership of professional bodies

Membership of consultancies

Contracts with publishers and providers of educational materials and/or services

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