WORLD ATHLETICSEXECUTIVE BOARDAPPOINTEDMEMBERS
2023 APPLICATION
FORM1WORLD ATHLETICS EXECUTIVE BOARD – APPOINTED BOARD MEMBERAPPLICATION FORM
The Application Form must be received by the Executive Board Appointments Panel by no later than
15 August 2023 (23:59 CET). This deadline will be strictly enforced. Application Forms must be sentby email to EB-candidates@worldathletics.org.
Please type in details in the highlighted fields
PART 1 - INFORMATION ABOUT THE APPLICANT

1.1. PERSONAL INFORMATION:Title
Family Name
Given Name
GenderDate Of BirthMale/ Femaleddmm

yyyy

Nationality
Preferred Language

1.2. APPLICANT CONTACT INFORMATIONHouse/Apartment No
Road/StreetTown/CityCounty/StateCountry
Telephone

Post/zip code
Daytime

EveningMobile

Email2PART 2 – ENDORSEMENT BY MEMBER FEDERATION OR AREA ASSOCIATION (OPTIONAL)
The[insert NAME OF MEMBER FEDERATION/AREA ASSOCIATION]
endorses the application by[insert NAME OF APPLICANT] for aposition as a World Athletics Appointed Executive Board Member(please tick)
MEMBER FEDERATION/ AREA ASSOCIATION INFORMATION
Please state the Member Federation or Area Association which is endorsing the Applicant.
Name of Member Federation/AreaAssociation:
Name and contact details of person
signing your Application Form onbehalf of the Member Federation/
Area Association:
Position of person signing your Formon behalf of the Member Federation/
Area Association:
List any current or past positions (withdate(s)) of the Applicant in the Member
Federation/Area Association:

SIGNATURESAPPLICANT SIGNATUREI DECLARE that the information included in this Application Form concerning my application for aposition as a World Athletics Appointed Executive Board Member is accurate and complete.
I confirm I have been provided with access to the World Athletics Constitution and its Rules, including
the Integrity Code of Conduct and have had the opportunity to read them. I understand that if I am
appointed, I will be an Applicable Person as defined in the Integrity Code of Conduct and bound by it.
(please tick)
I understand that World Athletics, will hold and process my personal data in order to fulfil the legitimate
interests of World Athletics in considering my application, which, if successful, may include processing
my personal data in order to fulfil my position on the Executive Board, publishing my name andbiography on the World Athletics website and/or otherwise providing this data to Member Federations
and other interested parties around the world. I agree to World Athletics doing so. (please tick)3Please fill in and sign as required.*

Signature

NameDateddmm

yyyy

Place (Town/City, Country)
A digital signature is acceptable

MEMBER FEDERATION / AREA ASSOCIATION SIGNATURE (only complete if Application is to beendorsed)
As the most senior officer of the Member Federation or Area Association*, I confirm that the Member
Federation / Area Association, by resolution of its Board, Executive Committee or equivalent body,endorses the application of this Applicant.
*Where the Applicant is the most senior officer of the Member Federation or Area Association,
this must be signed by the next most senior officer of the Member Federation or AreaAssociation.
Please fill in and sign as required

Signature

NameDate

ddmm

yyyy

Place (Town/City, Country)
A digital signature is acceptable

4

MEMBER FEDERATION / AREA ASSOCIATION STAMP (if available)

NOTE:
In addition to this form, Applicants must submit:• a letter detailing the Applicant’s suitability for one of the Appointed Executive Board Member
Positions, which clearly outlines their skills and experience, how they will make a contribution
to the Executive Board and reasons for applying; and• a CV/resume with the contact details of three referees.

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