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Crown Servant or British Council Registration

Isle of Wight Council

	Crown Servant or British Council Registration
	This form is to be used for the application to register or renew registration as a Crown Servant or British Council employee or spouse.

Please only enter one person's details per form.

If you need help filling in this form, please phone the Helpline on 01983 821000.

PLEASE NOTE: It is an offence to make false statements on this form.

Your Details

Title

Forename

Middle name/Initials

Surname

Are you 18 years old or over?

Yes

Are you 16 or 17 years old?

If so please give your date of birth.

Address where you would be resident or last residence, but for your (or your spouses) service abroad

*	Building/house name/number
*	Street address
*	Town Name
	County
*	Postcode

Present address

*	Building/house name/number
*	Street address
*	Town Name
	County
*	Postcode

Employment outside the United Kingdom

About your employment or your spouses employment outside the UK:

Please tick which phrase is correct

I am employed in a post outside the UK

my spouse is employed in a post outside the UK

I am leaving to take up employment outside the UK

my spouse is leaving to take up a post outside the UK

Which Service is this employment with?

the Crown

the British Council

Which Department do you or your spouse work for?

Please tick whether it is you or your spouse and name the Department.

you

your spouse

Department:

Which Post do you or your spouse hold?

Please tick whether it is you or your spouse and name the Post.

you

your spouse

Post:

Two versions of the register

If you do not want your name appearing on the Edited Register please tick here.

(see Notes)

	Declaration
	Please print this form and fill this section in by hand before returning your form to Electoral Services, Isle of Wight Council.

As far as I know the details on this form are true and accurate.

I am a British, other Commonwealth or Irish citizen.

Any previous declaration made is now cancelled.

Signed ...............................................................................

Name.................................................................................

Date...................................................................................

ATTESTATION, this declaration must be attested by one of the following people:

Crown Service application

* An officer from your department

* Someone nominated by your department

* Someone holding a service qualification through being employed on Crown Service in a post outside the UK

British Council application

* A British Council officer

* Someone holding a service qualification through being employed on Crown Service in a post outside the UK

Attesting Officer full name and signature

Stamp of transmitting department

For Office Use

	Postal / Proxy Voting Application
	You may complete this section to enable you to vote by post or by proxy. Please complete EITHER the section to vote by Post OR the section to vote by Proxy.

Address where you are registered to vote:

	Building/house name/number
	Street address
	Town Name
	County
	Postcode

For how long do you want a postal or proxy vote?

3. How long do you want a postal vote for?

until further notice

for a specific election, enter details in box A below

for a perios of time, enter details in box B below

BoxA

For the election(s) on

dd/mm/yyyy

Box B

For the period from

To

dd/mm/yyyy

dd/mm/yyyy

To vote by post click NEXT below, to vote by proxy click here.

	Postal Vote
	(Complete this part only if you wish to vote by post)

Address for Ballot Paper

	Building/house name/number
	Street address
	Town Name
	County
	Postcode

Click here to continue.

	Proxy Vote
	Please complete this section only if you want to vote by proxy. Please note if appointing a proxy: * Your proxy must be able to vote in the type of election concerned. * Your proxy cannot vote for more than 2 voters, including yourself, unless he/she is the husband/wife, parent, grandparent, brother, sister, child or grandchild of the voter.
	Please give Proxy details:

	Forename
	Middle names
	Surname

	Building/house name/number
	Street address
	Town Name
	County
	Postcode
	Address for Ballot Paper if proxy is unable to vote on your behalf at a polling staion
	Relationship of proxy to you ( if any)

Proxy's Signature

I confirm that I am capable of being and willing to be appointed to vote as the applicants Proxy.

	Applicants Declaration
	Please print this form and fill this section in by hand before returning your form to Electoral Services, Isle of Wight Council.

As far as I know the details on this form are true and and accurate. If I have appointed a proxy I confirm that she is willing and able to vote on my behalf.

Signature

Data Protection Act 1998

This application may be monitored by the Isle of Wight Council for regulatory, quality control or crime detection purposes. Information from this application will be processed in accordance with the Data Protection Act 1998 for the purpose of processing your particular enquiry/request. The Isle of Wight Council ("the Council") is the data controller. By completing this form you consent to the Council contacting you by email or nominated contact method in relation to your enquiry/request.

The information contained in this application may, in exceptional circumstances, be subject to disclosure to third parties under either the Data Protection Act 1998 or the Freedom of Information Act 2000 to the extent the law allows and in accordance with the Isle of Wight Council's Access to Information Policy . Disclosure will only be made where in all the circumstances it would be fair to do so and in the public interest.

Please note that the Council may process your information in the absence of consent for the purpose of crime prevention or detection so far as is in accordance with the law.

Sometimes we may use your information to keep you informed about services, goods or relevant issues that we believe may be of interest to you. If you wish to receive this information for these purposes please tick this box

To improve the quality of other services that we provide to you the Council wishes to hold your non-sensitive personal information on a secure central database. This will enable all Council services to use this information when they are providing a service to/for you. If you wish your non-sensitive personal information to be held by the Council please tick this box

Date printed: 07/03/2013