Annex B

Political Activity

	Candidate Name:
			Candidate Post Code:	

All applicants for a public appointment should complete the question below. This question is asked as it enables the monitoring of political activity of candidates for a public appointment in so far as it is already in the public domain. Neither activity nor affiliation is a criterion for appointment (except where statute dictates specific representation). If you are successful, the information will be published in the announcement of your appointment.

Please indicate which of the following activities you have undertaken during the past five years by ticking the appropriate box and by providing details of your involvement. Name the political party or body for which you have been active. If you have been or are an Independent or have sought or obtained office as a representative of a particular interest group, you should state this. You should tick all relevant categories.

Obtained office as a Local Councillor, District Councillor MP, MEP, MLA

 etc.	

Stood as a candidate for one of the above offices

Spoken on behalf of a party or candidate

Acted as a political agent

Held office such as Chair, Treasurer, or Secretary of a local branch of a  party

Canvassed on behalf of a party or helped at elections

Undertaken any other political activity which you consider relevant

Made a recordable donation to a political party*

	

None of the activities above apply                                                                                           		
				 
Name of Party for which activity undertaken

Conservative				Liberal Democrats			
					
Labour				Independent			

Other				Please specify		

Details of involvement: 

*  The Political parties, Elections and Referendums Act 2000 requires the Electoral Commission to publish a register of recordable donations (donations from any individual totalling £5000 in any calendar year, or more than £1000 if made to a subsidiary accounting unit such as a constituency association, local branch, women’s or youth organisation). These provisions became effective from 16 February 2001.
Note: This information is for monitoring purposes only and therefore will be detached from your application and will not be seen by the short listing panel. However, if you are short listed for interview, this will be shared with the selection panel. The reason for this, is that it is appreciated that such activities may have given you relevant skills, including experience gained from committee work, collective decision-making, resolving conflict and public speaking. If, therefore, you have had such experience and you consider it relevant to your application for this post, you should include it separately in the main body of your application form. You should not, however, identify the relevant political party in the application form.