Liverpool City Council

Personal and contact details

Name

Address

Postcode

Use the Lookup Postcode button to find the address.

If you cannot find the address, please enter it manually

Daytime telephone number

Evening telephone number / mobile

Email address

Your qualifications

Please list your qualifications, in particular any qualifications which you think are relevant to the position of Independent Person

Summary of experience

Please give a brief account of your experience including career, public and voluntary work together with the nature of your current or most recent occupation

Relevant expertise/skills

Please outline briefly any knowledge or expertise which you believe would be particularly relevant to your role as an Independent Person having regard to the selection criteria and role description

Further information

Why do you wish to be considered for appointment as Independent Person and what particular attributes do you believe you would bring to the role?

Please provide any additional information you may wish to give in support of your application - optional

References

References may be taken up for all applicants who are invited for interview

Your referees’ knowledge of you should be relevant to the person specification for the role(s) for which you are applying.

Referee 1 name

Referee 1 address

Referee 1 telephone number

Referee 2 name

Referee 2 address

Referee 2 telephone number

In submitting this application, I declare that:

I am not and have not during the past five years been a member, co-opted member or officer of Liverpool City Council;
I am not related to, or a close friend of, any member, co-opted member or officer of Liverpool City Council;
I have not during the last 5 years been a member, co-opted member or officer of Liverpool City Council
I do not have a public profile in party politics including a role on the management or selection committee(s) of a registered political party, nor have I been a candidate or canvasser for a registered political party at a local or national level;
I am not currently an officer or member, or co-opted member of any other relevant authority (this includes parish, district, county and unitary councils and Police and Fire Authorities), nor have been for the last five years;
I do not have an existing contractual or commercial relationship with Liverpool City Council; which could cause a potential conflict of interest.
I have not been convicted of a criminal offence (excluding minor traffic offences) in the last five years.
I have read the privacy notice attached to this Application Form.

View the privacy notice

Declaration agreement

I agree to the above declaration

Before you submit this form please review your answers below. If you need to change anything, use the 'previous' button on the bottom left to go back to a section. Then submit the form by selecting the 'Submit button' at the bottom of this page

Appointment as Independent Person or Substitute Independent Person - Application Form