Non-Executive Director Application Form -

Where did you hear about this role?(required)

Personal Details

Title:

First Names:(required)

Surname:(required)

Previous Surname:

Date of Birth:(required)

Residential Address:(required)

Postcode:(required)

Daytime Telephone Number:(required)

Mobile Number:(required)

Email address(required)

Independent References

Please provide name, address and position/occupation of two independent references. One must be your present or most recent employer. References will only be taken up if appointed. Please note that we are unable to receive testimonials or references from friends and relatives.

First Reference

Name of Referee 1:(required)

Position of Referee 1:(required)

Relationship to Applicant:(required)

Referee Organisation:(required)

Address:(required)

Postcode:(required)

Telephone Number:(required)

Email Address:(required)

Second Reference

Name of Referee 2:(required)

Position of Referee 2:(required)

Relationship to Applicant:(required)

Referee Organisation:(required)

Address:(required)

Postcode:(required)

Telephone Number:(required)

Email Address:(required)

Data Protection Consent

The Jersey New Waterworks Company Limited will process your data for the purpose of recruitment and selection activities for the position of non-executive director and related committees as applied for.

Under the Data Protection (Jersey) Law 2018, you have a right to obtain a copy of your personal data, processed by the Jersey New Waterworks Company Limited, either on computer or in manual files.

Declaration of Eligibility

(required)

I do not have an unspent conviction relating to any offence involving deception or dishonesty;

I am not an undischarged bankrupt nor have I made a composition or arrangement with, or granted a trust deed for, my creditors; and

I am not, nor have I ever been disqualified from acting as a director in any jurisdiction under any law or regulator. Specifically under the Company Directors Disqualification Act 1986 or order section 429(b) of the Insolvency Act 1986, Article 43 of the Bankruptcy (Désastre) (Jersey) Law 1990 or Article 78 Companies (Jersey) Law 1991; or under the Criminal Justice and Court Services Act 2000.

I declare that I am not disqualified from acting as a director/non-executive director (please tick to confirm and agree each statement above)

Confirmations

(required)

I confirm that the above information is factually correct.

I hereby give permission for verification of my references to be sought including address, professional and educational qualifications, references, Court Judgement checks etc.

File Uploads

Covering letter Upload(required)

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CV Upload(required)

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The closing date for the receipt of applications is 2 March 2020.

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Personal Details

Independent References

First Reference

Second Reference

Data Protection Consent

Declaration of Eligibility

Confirmations

File Uploads

Company Info

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