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					Application form: LMC Chair / _______

PUBLIC APPOINTMENTS CHAIR OF LIVESTOCK AND MEAT COMMISSION FOR NORTHERN IRELAND APPLICATION FORM
Notes on completion: 1. Applications must be made using this form. CVs are not acceptable. Please read the Information Pack and Guidance Notes before completing the application form in typescript or black ink (BLOCK CAPITALS). 2. The Commissioner for Public Appointments for Northern Ireland requires Departments to monitor the gender, age, ethnic origin, community background and disability of candidates to ensure that equal opportunity measures are effective. You are asked to complete these details in Section 3 of the form. As with all the information contained in the form, it is gathered, maintained and processed, strictly in accordance with our Data Protection Registration, for public appointment purposes only. 3. If you have any queries or require this form in another format you can contact us as per details at Note 5 below. 4. Your completed application form should be returned to the Department by 1700 hours on Thursday 12 March 2009. 5. Please return your completed application form to:Trevor Hanna Food Policy Branch Department of Agriculture and Rural Development Room 137, Dundonald House Upper Newtownards Road BELFAST, BT4 3SB Telephone: 028 9052 4616 Fax: 028 9052 4574 e-mail: Trevor.hanna@dardni.gov.uk

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Application form: LMC Chair / _______
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APPLICATION FOR A PUBLIC APPOINTMENT
Applications must be made using this form. CVs are not acceptable. Please use typescript or black ink (BLOCK CAPITALS).

1. HOW WERE YOU MADE AWARE OF THIS OPPORTUNITY? Newspaper or Journal Seminar Letter from the Department Internet     Word of mouth Elsewhere (Please specify  

2. PERSONAL DETAILS Surname: (Block letters) Forenames: (Please underline name by which you are known) Title: (Prof/Dr/Mr/Mrs/Ms etc.)

Home telephone: Mobile telephone: Permanent Address:

Office telephone: e-mail: Address for Correspondence:

Postcode:

Postcode:

3. MONITORING INFORMATION This information is required for monitoring purposes only and will not be used to determine your suitability for appointment. It will not be seen by the selection panel - the form for completion is therefore attached separately. MONITORING DETAILS – Please complete section 3 (attached separately)

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Application form: LMC Chair / _______
4. SUITABILITY FOR APPOINTMENT A. INDEPENDENCE OF CHAIRPERSON Have you had any commercial interests in the production of livestock or livestock products since 1 April 2008? Tick appropriate box Yes No

Notes: (a) If you ticked “Yes” you are not eligible to apply for this position. (b) If you have ticked “No” please provide details explaining how you consider that you meet each of   the essential criteria listed in Part B boxes (a) to (e) below; and  (if possible) the desirable criteria in Part C boxes (f) and (g) below. It would be helpful if you provide clear examples in each case using continuation sheets as necessary. As appropriate you should draw on your working life or personal life when providing your answers.

B. ESSENTIAL CRITERIA (a) Ability to engage effectively and influence strategic thinking with contacts at a senior level in Government and with other stakeholders of the LMC.

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Application form: LMC Chair / _______
(b) A proven track record at board level of leading or contributing to the strategic direction of an organisation.

(c) A knowledge of marketing within the agri-food industry.

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Application form: LMC Chair / _______
(d) Sound views on the future role of the LMC including a real commitment to the industry it serves.

(e) Excellent communication skills including ability to deal with the media.

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Application form: LMC Chair / _______
C. DESIRABLE CRITERIA (f) A knowledge of the livestock (cattle and sheep) and livestock products industry.

(g) A knowledge of the red meat industry structure and operation.

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Application form: LMC Chair / _______
5. PREVIOUS EMPLOYMENT AND/OR VOLUNTARY WORK EXPERIENCE Please give details of the main jobs you have undertaken (including your current job) and/or any voluntary work experience you have gained during the last 10 years. Please provide the dates that you started and ended the job, the title of your post, the name of your employer (if appropriate), and a brief description of your main responsibilities. If you have not been employed or undertaken any voluntary work in the last 10 years, please write “NONE”. Organisation (Name and Address) Job Title and Responsibilities Dates From To

6. PREVIOUS AND CURRENT PUBLIC APPOINTMENTS List all current and previous public appointments, beginning with the most recent and working back, giving the years you held the appointment, the position, the remuneration received and the name of the public body. If you have not held any previous public appointments, please write “NONE”. Body Position Period of Appointment From To
Remuneration

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Application form: LMC Chair / _______
7. QUALIFICATIONS This section is not mandatory. You need only complete this section if you feel it is relevant to your application. If not, please go to Section 8. Qualification Awarding Institution

8. PROBITY AND CONFLICTS OF INTEREST 8. INTERESTCONFLICTS OF INTEREST Before you complete this section, it is important that you read the leaflets “Probity & Conflicts of Interest Guidance for Candidates” and “Complaints and Conflict of Interest: Information Guidance” which are included in your information pack. Have you, or your immediate family, any business or other interests or personal connections that might be construed as being in conflict with the appointment for which you have applied? Are there any other probity issues, which might cause embarrassment if, in future, they are raised in public? Yes No

If you answered yes, please provide details below

Any potential conflicts of interest detailed above will not prevent you from being called for interview but may, if appropriate, be explored with you at that time to establish how you would address the issue should you be successful in your application.

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Application form: LMC Chair / _______
9. DECLARATION I have read the leaflets “Probity & Conflicts of Interest Guidance for Candidates” and “Complaints and Conflict of Interest: Information Guidance” and have completed Section 8 accordingly. I understand that, if appointed, I must raise with the Head of the Department of Agriculture and Rural Development’s Farm, Food and Environmental Policy Division or the Chief Executive of the Livestock and Meat Commission for Northern Ireland any probity or conflict of interest issues that might arise during my term of appointment and that my failure to do so could lead to my appointment being terminated. I have read the Information Pack and Guidance Notes for this appointment and understand my responsibilities in relation to statutory disqualifications and public appointments. I declare that the information I have given in support of my application is true and complete to the best of my knowledge. I understand that, if I am appointed and the information I have provided is incorrect, or any of the statements made in this declaration are untrue, or subsequently circumstances arise at any time before the end of my term of office which would render any such statements untrue, then my tenure of office may be terminated. I understand and accept that the information I have provided will be processed by the Department of Agriculture and Rural Development, in accordance with its Data Protection Registration, for the purposes of making public appointments. This may involve disclosing information to other Government Departments, the Commissioner for Public Appointments for Northern Ireland and anonymously in response to Parliamentary Questions and other enquiries. I also understand and accept that, if appointed, my name will be published in the Public Appointments Annual Report. Signature: Date:

The Department takes data protection and freedom of information issues seriously. It takes care to ensure that any personal information supplied to it is dealt with in a way which complies with the requirements of the Data Protection Act 1998. This means that any personal information you supply will be processed principally for the purpose for which it has been provided. However, the Department may also use it for other legitimate purposes in line with the Data Protection Act 1998 and Freedom of Information legislation. These include (where applicable):         Administration of the Common Agricultural Policy and other aid schemes; The production and safety of food; Management of land and other environmental controls; Animal health and welfare; Occupational Health and Welfare; Compilation of statistics; Disclosure to other organisations when required to do so; and Disclosure under the Freedom of Information Act 2000 or the Environmental Information Regulations 2004 where such disclosure is in the public interest.

REMINDER: The CLOSING TIME and DATE for receipt of applications is 1700 hours on Thursday 12 March 2009.

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