Application form

Application to fill vacancy of Parish Councillor for West Pennard Parish Council in the ward of The Pennards Ditcheat

If successful, you will be required  to complete an entry in the parish council's register of members' interests. This involves putting on public record your address, employment, relevant financial and other interests.

Title
Mr
Mrs
Ms
Full Name *
Address *
Phone *
+44
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    Email *
    Will you be at least 18 years old on the date of the meeting*
    Yes
    No
    In order for your eligibility to be confirmed please tick all the following that apply to you.*For full detail on eligibility please refer to your district council's electoral officer
    On the current electoral register for the parish/ward (on-going requirement; you are required to remain on the register throughout your term of office)
    Have lived in the parish or within 3 miles of the parish boundary during the whole of the 12 monthsbefore the day of nomination and election
    Main place of work during the last 12 months before the day of nomination and election is based in the parish
    Occupy as owner or tenant property within the parish for 12 months before the day of nomination and election

    You are disqualified if you are employed by the parish council, are subject to a Bankruptcy Restriction Order, have been convicted of a criminal offence with imprisonment for 3 months or more, including suspened, within the last 5 years. Subject to the notification requirements of part 2 of the Sexual Offences Act 2003, disqualified from being a councillor of a principal authority as a result of electoral offences, convicted for failure to register or declare a disclosable interest under the Localism act.

    I am not aware of any disqualification to my serving as a councillor - Signed
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