Branch Chairs - Application Form

Application Form - Branch Chairs
In order to apply for the Branch Chair role, you must be an FPD member of Prime Dispute.
Do not complete this form if you do not want Prime Dispute to collect, store, share and process your information.

Mandatory
All the boxes in this section with * are required to be completed by all who are submitting this form, without which the application for Branch Chair cannot be processed

* Indicates required field

Title (e.g. Dr. / Ms. / Mrs. / Mr.): *

Name:

First / Given *

Middle *

Last / Family *

Gender (Female / Male / Other): *

Company Name: *

Email: *

Re-Confirm Email Address provided above *

Landline: *

Mobile (e.g. +44-xxxxx-xxxxx) *

Office Address (i.e. where all written communication, if any, will be dispatched) *

Line 1

Line 2

City

State

Zip Code

Country

Website / Blog Page: *

Social Media Links (e.g. LinkedIn, Twitter, Instagram, Facebook, etc.): *

Please tick the Branch Chair region you are applying for (please note you can only tick one box): *

Please specify the exact location of the Branch: *

The Branch Chair must be fluent in both written and spoken English. Please confirm: *

Yes No

The candidate should meet one of the following requirements: *

I have permanent residency within the country (including the region for which I have applied) I am working within the region at the time of completing and submitting the application for Branch Chair (evidence may be required by Prime Dispute). Other

Please confirm you have read and agree with all the terms stipulated within the Guidance note for Branch Chair *

Yes No

If you have selected 'Other' please specify: *

Candidates should declare material interests which are relevant to the business of Prime Dispute in order to prevent conflicts of interest or the perception of conflicts of interest arising. Please provide comments: (any commercial interests or membership of other societies, institutes, political parties or other bodies which might be relevant if they were appointed) *

Candidates should inform their nominators of any material interests or affiliations which could reasonably be expected to influence their decision to nominate them. This will be used within candidate election profiles and candidates should declare any involvement likely to be material to members in casting their votes. Please provide comments: *

Election Statement

Please provide an overview regarding your background. The content is entirely up to you e.g. you could provide a C.V. or a manifesto or explain your vision for the future of dispute/conflict resolution (if you would like Prime Dispute to use your FPD Digital profile, please let us know). Please provide: *

Photograph Please insert an up-to-date and good quality head and shoulders digital passport sized. Full figure or out of focus photos will not be accepted. *

Max file size: 20MB

CV/Manifesto *

Max file size: 20MB

Please note: Candidates may not make damaging or inaccurate remarks about other candidates or Prime Dispute. Should the contents of an election statement cause concern, Prime Dispute Executive (Directors) will decide whether the candidate must make amendments or whether to take any action).

Mandatory
All the boxes in this section are required to be completed by all who are submitting this form, without which the application for Branch Chair cannot be processed

I declare that the information I have provided on this application form is true and accurate. I agree to abide by the; Guidance Note for Branch Chairs, User Agreement, Business Ethics and Conflict of Interests Policy, Terms and Conditions*** (Please do not tick yes, if you do not want Prime Dispute to collect, store, share and process your information), or similar. *

Yes

Have you ever been convicted of a criminal offence, other than a minor motoring offence such as parking os speeding? If so, please give details. *

Name:

First / Given *

Middle *

Last / Family *

Date *

* This is a required field and will need to be completed before you can submit your application.

Please note: Once you click submit your application will be sent to our team to review.

*** Please read our Terms & Conditions fully- You confirm you opt in, of receiving information or advertisements from us. Prime Dispute will collect, store, share and process member information within and outside the UK and comply with all data protection laws. If you have any questions, please contact Prime Dispute.

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Branch Chairs​​aPPLICATION Form

Application Form - Branch ChairsIn order to apply for the Branch Chair role, you must be an FPD member of Prime Dispute.Do not complete this form if you do not want Prime Dispute to collect, store, share and process your information.

Branch Chairs
aPPLICATION Form

Application Form - Branch Chairs
In order to apply for the Branch Chair role, you must be an FPD member of Prime Dispute.
Do not complete this form if you do not want Prime Dispute to collect, store, share and process your information.