OFFICIAL SENSITIVE
CANDIDATE SUMMARY AND EQUAL OPPORTUNITIES
The information in Parts 5-7 of the Candidate Summary Form is not seen by the
appointments/selection panel.
PART 1: CANDIDATE SUMMARY
POSITION APPLIED FOR:
Member NERC Council
TITLE
SURNAME
FIRST NAME
INITIAL(S)
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enter text.
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text.
ADDRESS FOR CORRESPONDENCE
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CONTACT TELEPHONE NUMBER(S)
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EMAIL ADDRESS
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CURRENT/MOST RECENT EMPLOYER
(ORGANISATION)
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CURRENT/MOST RECENT JOB
TITLE
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REFERENCES
Please provide the names of two referees who could be approached to provide assurance
regarding your suitability for the role. You will be informed prior to contact being made with
the referees.
Referee one
Referee two
Name
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Email address
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OFFICIAL SENSITIVE
PART 2: POTENTIAL CONFLICTS OF INTEREST
Please indicate any business or personal interests or connections, which if you are
appointed, might represent a conflict, be misconstrued or cause embarrassment to the
Council. These could include financial interests, shareholdings, current connections within
the Council’s field of work, membership of societies, activities or associations or employment
of a partner or friend in the Council’s field of work. You should note that Council members
are required to declare their interests on a publicly available register.
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PART 3: MONITORING
To help us to monitor the effectiveness of our advertising and plan for future recruitments
please tell us how you became aware of the vacancy:
Research Council/BIS
website
Cabinet Office Public
Appointments website
Advert in press
From your university
Alerted by Research
Council
Other (please specify)
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OFFICIAL SENSITIVE
PART 4: FUTURE IMPROVEMENTS
The responses provided by applicants in this section are very useful and allows for
improvements to be made to future rounds of Council appointments.
1
What attracted you to the
position?
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2
Are there any aspects that
could be perceived as a
barrier to completing this
role? E.g overnight stays,
evening meetings, length
of term served?
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3
What steps could be taken
to encourage applicants
from underrepresented
groups?
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4
What type of support
would you find helpful?
E.g. mentoring, coaching
and/or training?
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OFFICIAL SENSITIVE
PART 5: EQUAL OPPORTUNITIES
Please tick or complete the appropriate boxes. The following information is requested for
monitoring purposes only and will not form part of the sifting or shortlisting process.
AGE
DATE OF BIRTH Click here to enter text.
AGE Click here to enter text.
GENDER
FEMALE Click here to enter text.
MALE Click here to enter text.
ETHNIC ORIGIN
Please show which group best describes your ethnic origin or descent by ticking only one of
the boxes in the right hand column below.
A. White
B. Mixed
C. Asian or Asian British
British
White & Black
Caribbean
Indian
Irish
White & Black African
Pakistani
Other
White & Asian
Bangladeshi
Other
Other
D. Black &
E. Chinese
F. Other Ethnic
Group
G. Withheld
Black British
Caribbean
African
Chinese
Withheld
Please Specify:
Other
DISABILITY
Do you consider yourself to have a disability as defined by the Equality Act 2010: i.e. ‘a
physical or mental impairment which has a substantial and long-term adverse effect on the
person’s ability to carry out normal day-to-day duties? If YES, please tell us separately about
any adaptations which you may require either to carry out the role or to participate in the
selection process.
YES ☐
NO ☐
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OFFICIAL SENSITIVE
PART 6: OTHER PUBLIC APPOINTMENTS HELD
Please give the following details of any other position you hold to which you were appointed
by a Government Minister. You should note that if you are successful the Department is
required to release these details in the press notice announcing your appointment. The
proposed wording will be cleared with you.
Body
Appointment 1
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text.
Appointment 2
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text.
Appointment 3
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text.
Position type
(Chair, Member, other)
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text.
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text.
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text.
Appointing authority
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text.
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text.
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text.
Start date
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text.
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text.
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text.
End date
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text.
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text.
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text.
Remuneration
(Honorarium, Salary
etc)
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text.
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text.
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text.
Continue on a separate sheet if necessary.
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OFFICIAL SENSITIVE
PART 7: POLITICAL ACTIVITY
All applicants for appointment to the Research Councils should complete the question
below. This question is asked as it enables the monitoring of political activities of candidates
for a public appointment in so far as such activities are 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 provided will be published with the announcement of
your appointment. Again, the proposed wording will be cleared with you.
Please indicate which of the following activities you have undertaken in the past five years
by ticking the appropriate box and by providing details of your involvement. Name the 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.
a.
☐ Obtained office as a Local Councillor, MP, MEP or like elected member
☐ Stood as a candidate for one of the above offices
☐ Spoken on behalf of a party or candidate
b.
☐ Acted as political agent
☐ Held office as Chair, Treasurer or Secretary of a local branch or party
☐Canvassed on behalf of a party or helped at elections
☐ Undertaken any other political activity which you consider relevant
c.
☐ made a recordable donation to a political party
d.
☐ none of the above activities apply
Name of Party for which activity undertaken:
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Details of involvement:
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Note: This form is for monitoring purposes only and therefore will be detached from your
application and will not be seen by any selection panels. However, 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.
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