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1 Guidance Notes for Completion of Application Forms Thank you ...

1 Guidance Notes for Completion of Application Forms Thank you ...

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Declaration <strong>of</strong> InterestsIn order to maintain the highest standards <strong>of</strong> conduct, BHG staff members, prospective BHG staffmembers, Board members and committee members are required to declare any known potential oractual conflict <strong>of</strong> interest by completing and submitting this <strong>for</strong>m. An interest may include a familyrelationship or close personal friendship with consultants, contractors or suppliers to the Group,private work and membership <strong>of</strong> other voluntary organisations and statutory bodies.Please complete the following sections to ensure all known potential or actual conflicts <strong>of</strong> interest arerecorded:a. Name:…………………………………………………………………………………………………..b. Current position / vacancy applied <strong>for</strong>:………………………………………………………………c. Are <strong>you</strong> related to or a close personal friend <strong>of</strong> any current employee or Board member <strong>of</strong> BroadlandHousing Group?YES / NOIf yes, please give details:…………………………………………………………………………..d. Are <strong>you</strong> currently residing in a Broadland Housing home? YES / NOIf yes, please give <strong>you</strong>r address:…………………………………………………………….........e. Are any <strong>of</strong> <strong>you</strong>r relatives or close personal friends currently residing in a Broadland Housinghome? YES / NOIf yes, please provide details:………………………………………………………………………f. Are <strong>you</strong>, any <strong>of</strong> <strong>you</strong>r relatives, close personal friends or anyone in <strong>you</strong>r household currently aBroadland Meridian service user?If yes, please provide details:g. Is there any other existing or potential contractual relationship between BHG entities and <strong>you</strong>rself,a relative, a close personal friend or a member <strong>of</strong> <strong>you</strong>r household? YES / NOIf yes, please provide details:………………………………………………………………………h. Are <strong>you</strong> a principle proprietor or director concerned with the management <strong>of</strong> any company, firm orpractice with which any <strong>of</strong> the entities within BHG does business or to whom it makes payments?YES / NOIf yes, please provide details:………………………………………………………………3

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