Forms New

Application for Co-option

Full name and title

About you

In the box below tell us a little about your background, skills and experience that might be useful if you join the parish council.

Reasons for applying

Please explain here your reasons why you want to be a member of the Town/ Parish Council

Signature

Date

Eligibility to be a Parish Councillor

Full name and Title

Home address   

Home telephone             

Mobile telephone           

Email address    

It is a condition of being a Parish Councillor that your name be made public via notice boards and the parish council website.  You may need to disclose your phone and email address to deal with parish council matters.  Do you agree to this?  Yes   /   No (please circle)

Are you a British, Commonwealth or other European Union Citizen and not require leave to enter or remain in the United Kingdom or have indefinite leave to remain? Yes   /   No

Are you aged over 18? Yes   /   No

To qualify you must be able to answer ‘Yes’ to at least one of the questions below

a) Are you on the electoral register for South Kelsey and Moortown Parish Council? Yes   /   No

b) Have you lived either in parish of South Kelsey and Moortown or within 3 miles

of its boundary, for at least a year? Yes   /   No

c)  Have you been the owner or tenant of land in South Kelsey and Moortown parish

for at least year? Yes   /   No

d) Have you had your only or main place of work in parish of South Kelsey and

Moortown for at least a year? Yes   /   No

You must be able to answer ‘No’ to all the questions below to be eligible to serve as a councillor.

1. Are you the subject of a bankruptcy restrictions order or interim order? Yes   /   No
2. Have you within the last five years been convicted of an offence in the UK, 

the Channel Islands or Isle of Man and has been sentenced (whether

suspended or not) to imprisonment for three months or more without the

option of a fine? Yes   /   No

3. Are you disqualified by order of a court from being a member of a  local authority? Yes   /   No
4. Employed by South Kelsey and Moortown Parish Council, a joint committee or holds a paid office? Yes   /   No
5. Subject to the notification requirements of the Sexual Offences act 2003

or Sexual Risk Orders?

Signature

Date