Advisor Application

1

Personal Details

Tell us who you are and how to reach you.

Full Name *

Preferred Title (Dr./Prof./Mr./Ms., etc.) *

Contact Number (WhatsApp) *

Email Address *

Current City / Country of Residence *

Nationality *

LinkedIn / Professional Profile Link

2

Professional Background

Help us understand your career and standing.

Highest Qualification *

Field of Specialisation *

Total Years of Professional / Domain Experience *

Current Organisation / Affiliation *

Current Designation / Role *

Other Boards / Advisory Positions Currently Held

Briefly summarise your professional background and areas of expertise *

3

Area of Advisory & Availability

Tell us where and how you’d like to contribute.

1. Which domain would you primarily advise on? (Tick one primary choice; you may tick a second area of secondary expertise) *

Nutrition Science Governance Social Impact

2. What form of advisory engagement are you open to? *

Advisory Board Member (Ongoing) Strategic Advisor for a Specific Initiative / Project Ad-Hoc / Occasional Advisory Consultation Honorary Advisor

3. What is your preferred mode of engagement? *

Remote / Virtual Meetings In-Person (as required) Hybrid

4

Relevant Experience & Standing

Share the experience that informs your advisory capacity.

1. Summarise your leadership roles, board positions, or senior appointments relevant to Nutrition, Science, Governance, or Social Impact. Include organisation names, duration, and your role. *

2. List key publications, policy contributions, awards, or recognitions relevant to your domain expertise.

3. How do you envision contributing to IIMSAM’s strategy, policy, or programme design in your area of expertise? *

5

Areas of Expertise

Which of the following areas of expertise apply to you?

6

Resume / CV & References

Please attach your CV or biography and share your references.

Resume / CV or Professional Biography Upload your CV or biography Drag & drop your file here, or click to browse. PDF, DOC or DOCX · up to 5 MB

Professional References (Reference 1 required; Reference 2 optional)

Reference 1

Name *

Organisation *

Designation *

Contact Details *

Reference 2 (optional)

Name

Organisation

Designation

Contact Details

7

Declaration & Agreement

Please review the following before submitting your application.

By submitting this application, I confirm that:

I confirm that the information provided in this application is true and accurate to the best of my knowledge.
I understand that this is a senior advisory role with IIMSAM, a UN-affiliated institution, focused on guiding strategy, policy, and programme design, and not an operational or employment position.
I agree to provide guidance and counsel in good faith, within the scope and frequency of engagement agreed with IIMSAM.
I will disclose any actual or potential conflict of interest that may arise in connection with my advisory role.
I will maintain confidentiality regarding any sensitive organisational, strategic, or beneficiary information accessed during my engagement.
I will represent IIMSAM responsibly and professionally, and uphold its values while engaging with partners, governments, media, and stakeholders.
I understand that the terms of my appointment, including tenure and any honorarium (if applicable), will be formally confirmed separately prior to commencement of the advisory role.

I have read and agree to all the terms of the Advisor programme stated above.

Advisor’s Signature * Upload your signature Drag & drop your file here, or click to browse. PNG, JPG, WEBP or PDF · up to 1 MB