Hacked Off application form

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					Application Form
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Your details


Other names:




Your education (please provide dates in each section)

Institutions attended:

Examinations taken and results:

Professional training or relevant memberships:
Employment history

Present or most recent employer:


Job title:



Salary / rate of pay:

Employed from:                           To:

Reason for leaving:

Previous employment

Please give details of all the other jobs you have held over the last 10 years. Please account for the
last three years fully giving the dates of any periods when you were unavailable for work, or were
undertaking voluntary work. Please add more rows as necessary.

Dates             Employer           What was your job title? Describe the work       Reason for
                                     you did.                                         leaving

Please tell us why you applied for this job and why you think you are the best person for the job.

Please tell us about the skills you used and/or learned in your previous employment or in other
contexts, and how they fulfil the job description.

Please give your assessment on Hacked Off’s current position and should be the key facets of the
next phase of the campaign, bearing in mind that Jeremy Hunt has said that he imagines “we will
have a short intense period of debate after we get the Leveson recommendations in October, [and]
between October and Christmas will be a very important period for actually resolving the future of
media regulation.”
Final details

Have you ever been convicted of a criminal offence?                                       YES / NO
(declaration subject to the Rehabilitation of Offenders Act 1974)

Is there anything else we should know that may affect your suitability to work in a highly scrutinised
campaigning role?                                                                         YES / NO
(Please give details if necessary or submit them in a sealed letter FAO The Director)

Please tell us if there are any times when you will not be available for interview on 29-31 August.

Please give details of two employer referees, including one for your current or most recent
employer. We will not contact referees before making an offer.

I can confirm that to the best of my knowledge the above information is correct and complete. I
accept that providing deliberately false information could result in my dismissal.

Signature                                Date

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