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Co-option Eligibility and Application Form

1. In order to be eligible for co-option as a Wylam Parish Councillor you must be a British subject, or a citizen of the Commonwealth, or the European Union.  You must also be 18 years of age or over on the “relevant date”, that being the day on which you are nominated, or if there is a poll, then the day of the election. You must additionally be able to agree with the following qualifications set out below:

Please ✔ which of the following four points applies to you.

  1. I am registered as a local government elector for the parish ▢
  2. I have, during the whole of the twelve months preceding the date of my co-option, occupied as owner or tenant, land or other premises in the parish ▢
  3. My principal or only place of work during those twelve months has been within the parish ▢
  4. I have, during the whole twelve months, resided in the parish or within 3 miles of it ▢

2.    Please note that under Section 80 of the Local Government Act 1972, a person is disqualified from being elected as a Local Councillor or being a member of a Local Council if he/she:

  1. Holds any paid office of or employment with the local council (other than the office of Chairman) or of a joint committee on which the Council is represented; or
  2. Is a person who has been adjudged bankrupt or has made a composition or arrangement with his/her creditors (but see below); or
  3. Has within five years before the day of election, or since his/her election, been convicted in the UK, Channel Islands or Isle of Man of any offence and has been sentenced to imprisonment (whether suspended or not) for not less than three months without the option of a fine; or
  4. Is otherwise disqualified under Part III of the Representation of the People Act 1983 for corrupt or illegal practices.

This disqualification for bankruptcy ceases in the following circumstances:

  1. If the bankruptcy is annulled on the grounds that either the person ought not to have been adjudged bankrupt or that his/her debts have been fully discharged;
  2. If the person is discharged with a certificate that the bankruptcy was caused by misfortune without misconduct on his/her part.
  3. If the person is discharged without such a certificate.

In (i) and (ii) above, the disqualification ceases on the date of the annulment and discharge respectively.  In (iii), it ceases on the expiry of five years from the date of discharge

(insert name CAPS) ………………………………………………………………………………… Signature………………………………………………………………………………………………...

hereby confirm that I am eligible to apply for the vacancy of Wylam Parish Councillor and that the information given on this form is a true and accurate record.

Address for Correspondence

 

 

 

 

Email:

Tel:

Mobile:

Are you over 18?   Yes/No

Please detail any experience you have that may be relevant to Wylam Parish Council. (If necessary please continue on a separate sheet of paper).

 

 

 

 

 

Is there any other information you would like to disclose regarding your application?  (If necessary please continue on a separate sheet of paper).     

 

 

 

 

Signed…………………………………………………………
Dated………………………………………………………….

Please return your completed form by  to:

Mrs. Marie Moore,
The Clerk to Wylam Parish Council

Wylam Institute,
Church Road,
WYLAM
Northumberland
NE41 8AP. 

Telephone:  (01661) 852498
Email:  This email address is being protected from spambots. You need JavaScript enabled to view it.