Declaration of Public Appointments Held Is this your first public appointment? Yes/No public appointments currently held and any remuneration- please state below: Body Government Department Term of Appointment Remuneration Sponsor POTENTIAL OR ACTUAL CONFLICTS OF INTEREST If you or a family member have any personal or business interest or potential conflict of interest with the activities of the Body you will be expected to declare this. You will also be required to uphold the standards of conduct established by the Committee of Standards in Public Life, also known as the Nolan Principles (please see last page). Please give details in the box below of any business or other interests or any personal connections which, if you were appointed, could present a conflict of interest if holding this role. These could include financial interests or share ownership, membership of societies, activities, associations or employment of a partner or friend in the field in which the public body operates. Any potential or actual conflicts of interest detailed here will not prevent you forward to interview but may, if appropriate, be explored with you during your interview to establish how you would address the issue(s) should you be successful in your application. If there are no potential conflicts of interest, please write ‘none’. POLITICAL ACTIVITY DECLARATION Have you undertaken any political activity for a political party in the past five years? No Yes If please indicate the activity undertaken and for which party/parties: ‘Yes’, Party/Parties: held office public speaking
Declaration of Public Appointments Held Is this your first public appointment? Yes/No public appointments currently held and any remuneration- please state below: Body Government Department Sponsor Term of Appointment Remuneration POTENTIAL OR ACTUAL CONFLICTS OF INTEREST If you or a family member have any personal or business interest or potential conflict of interest with the activities of the Body you will be expected to declare this. You will also be required to uphold the standards of conduct established by the Committee of Standards in Public Life, also known as the Nolan Principles (please see last page). Please give details in the box below of any business or other interests or any personal connections which, if you were appointed, could present a conflict of interest if holding this role. These could include financial interests or share ownership, membership of societies, activities, associations or employment of a partner or friend in the field in which the public body operates. Any potential or actual conflicts of interest detailed here will not prevent you forward to interview but may, if appropriate, be explored with you during your interview to establish how you would address the issue(s) should you be successful in your application. If there are no potential conflicts of interest, please write ‘none’. POLITICAL ACTIVITY DECLARATION Have you undertaken any political activity for a political party in the past five years? No Yes If ‘Yes’, please indicate the activity undertaken and for which party/parties: Party/Parties: held office public speaking