Regulation 23(1)
1. The applicant’s full name, date of birth, business address, email address and telephone number.
2. The 2011 Act panel(s) to which the applicant wishes to be appointed.
3. The corresponding 1975 Act panel(s) which the applicant was a member of for a continuous period from 1st April 2015 to 31st March 2016.
4. For each corresponding 1975 Act panel referred to in paragraph 3, the date on which the applicant’s term of appointment began and the date on which it expired or would have been due to expire if the term of that appointment (so far as it extended to Scotland) had not ceased by virtue of the repeal of the 1975 Act.
5. A statement, signed and dated by the applicant—
(a)that the information given in the application is complete and correct; and
(b)that, for the purposes of determining the application, the applicant consents to the Scottish Ministers having access to and using—
(i)any information that the applicant provided with any application for appointment as a member of a 1975 Act panel; and
(ii)any relevant information held or advice provided by the Institution of Civil Engineers as to whether the applicant is fit and qualified for the appointment.