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Application for a County Farm
Surname: Initials:
Email address:
Date of Birth:
Post Code:
Known as:
Please answer all of the following questions by typing in the boxes, or you can print out and
complete using black ink. Please answer as fully as possible and add any other information that you
feel may be helpful to the Selection Panel.
Please state below details of the farm you wish to apply for:
Personal Details
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Download the latest version from or contact your IT help desk.
Name of Farm and Parish
Telephone Number: Mobile Number:
Area (ha)Best Offer/Proposal
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Date Started: Present Income:
Present Occupation
Employer (Name and address)
Description of work and responsibilities
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Previous Experience (most recent first)
(name and address)
Description of work and
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Training in Agriculture and Horticulture
Current Farming
Please list details of any land you currently farm, including location, ownership, length of term,
your involvement and what you would plan to do if you were to be successful in your application for
this holding.
University or
Training Centre
Day Release
or Evening
Exams taken
and Results
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Future Operations
Please give a brief general description of the farming or horticultural system you
would follow for the business you intend to set up, and how you see it developing:
please add on a separate sheet.
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How did you find out about this farm?
Data Protection Act
The personal information given on this form by the successful applicant will be held in
confidence in our computer systems to assist the Council in the management of its Estate.
Rehabilitation of Offenders Act
Have you been convicted, cautioned or
court martialled for any criminal offence?
Is there any court action pending against you?
If yes to either of the above, please give details below:
n n
n n
Yes No
Please give the names, addresses and telephone numbers of two people who are prepared to give a
reference on your behalf and state how they are known to you. (These should not be a relative).
Where applicable, one of these might be the Principal or Tutor of any agricultural or horticultural
establishment you have attended.
Name and address
Telephone Number:
Name and address
Telephone Number:
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Are you related to or do you have a close personal relationship
with any Councillor or employee of Suffolk County Council?
If yes, please state their name and position:
n n
Yes No
Bank Reference:
Name, contact name and address of your bank:
Do you give your consent for a Banker’s reference to be taken up?
You will be responsible for any costs incurred when the Council seeks a banker’s reference.
I confirm that the information I have given on this form is correct and complete and that misleading
statements may be sufficient for any agreements to be cancelled. I understand that, in the event of being
shortlisted for interview, I will be required to complete a confidential declaration in respect to my health.
I understand that if I knowingly withhold or supply incorrect information, my application may be
cancelled and any tenancy promised or already granted may be withdrawn.
When completed this application form should be forwarded, along with the projected budgets and
cashflow forms (where applicable) to:
Matthew Lee, Corporate Property Advisor (County Farms), Endeavour House, 8 Russell Road,
Ipswich, Suffolk IP1 2BXTel: 01473 264109 or by e-mail to:
n n
Yes No
Applicant’s signature: