NOMINATION OF A MEMBER SEEKING ELECTION AS A DIRECTOR OF THE

AUSIMM BOARD: 2019-2021

Details of member seeking to stand for election as a Director of the AusIMM Board:

Name: AusIMM Membership No: Member Grade:

Profession: Location: AusIMM Member since:

In seeking to stand for election as a Director of the AusIMM Board, I make the following statement regarding my ability to meet the criteria for Board Directors
(as adopted by the AusIMM Board on 9 February 2015 and clarified on 10 October 2016):

Candidacy criteria for Board Directors – candidates Summary statement by candidate against each criteria: Proposer Supporter 1 Supporter 2 Supporter 3
must: initials initials initials initials

EITHER
a) Have experience as a leader of an AusIMM, Branch,
Committee or Society for a minimum of three years;

OR
b) Have experience as a Director of a substantial
corporate or not-for-profit organisation, or a relevant
professional body, for a minimum of three years; AND
be willing to undertake an induction to familiarise
yourself with the structure, purpose, strategy and
operations of the AusIMM before taking up office;
AND IN ADDITION TO MEETING CRITERIA (a) and/or (b):
c) Be a graduate of a recognised Australian Institute of
Company Directors or similar Director’s course, be
willing to undertake such a recognised course or a
Corporate Governance and Leadership course provided
or approved by the AusIMM which provides governance
training, including the specific governance requirements
of the AusIMM Board and Communities of Interest.

Confirmation of candidacy (candidate to initial each statement and sign below): Initials

I hereby confirm that I wish to stand for election as a Director of the AusIMM Board. I attest that I am eligible to stand (being an Honorary Fellow, Fellow or Member in good
standing) and that I meet the specified candidacy criteria.
I hereby also confirm that I agree to the Board’s requirement that I will not, nor allow others on my behalf to, promote my nomination to other members of the AusIMM for
their vote through any form of broadcast campaign. This includes a prohibition on bulk emails, texts, phone calls, letters, social media and website platforms.
I hereby also agree that this completed nomination form may be made available to AusIMM members to review as part of the conduct of the election.

Candidate for election:

Printed Full Name Signature Date

Proposer and supporters of the nomination:
In signing and initialing this nomination form as a Proposer or Supporter of the nomination, I attest that I am a
Corporate Member (Honorary Fellow, Fellow or Member) of the AusIMM in good standing.
I furthermore verify that I believe the candidate meets the candidacy criteria for Board Directors adopted by the
AusIMM Board and as set out in this document.

Proposer (Printed name):

Member Grade & Membership No:

I hereby agree to the nomination and

confirm the candidate meets the (Signature & Date):
candidacy criteria

Supporter 1 (Printed name):

Member Grade & Membership No:

I hereby support the nomination and

confirm the candidate meets the (Signature & Date):
candidacy criteria

Supporter 2 (Printed name):

Member Grade & Membership No:

I hereby support the nomination and

confirm the candidate meets the (Signature & Date):
candidacy criteria

Supporter 3 (Printed name):

Member Grade & Membership No:

I hereby support the nomination and

confirm the candidate meets the (Signature & Date):
candidacy criteria

Submission of completed candidate nominations

This form, plus any attachments supporting the candidate’s claims to meet the criteria, must be provided to the
AusIMM CEO by 5pm AEST Tuesday 31 July 2018.

Note that nominations received after this time will not be accepted. Nominations will be reviewed by the Nominations
Committee of the AusIMM Board and nominees or their supporters may be requested to provide further evidence of the
statements made on this nomination form.

Once an election is confirmed, candidates will also need to provide the following:
• A high-quality head-and-shoulders colour photograph suitable for a variety of publications, and
• A brief statement (maximum of 150 words) incorporating a summary of your professional qualifications to be a
Board Member and what you hope to contribute to the Board. (Any statements exceeding 150 words will be edited
accordingly)

Submission options:
• Email to coo@ausimm.com.au
• Post to PO Box 660, Carlton South, VIC, 3053, Australia – marked CONFIDENTIAL and for attention: CEO

Queries about the nominations and/or election process should be directed to the CEO via email at
coo@ausimm.com.au or phone +61 3 9658 6111.