Devolved Nation Board Nomination Form (Wales)

Thank you for your interest in joining the Welsh Board. There are two vacancies for Consultant, Specialist Grade, Staff Grade and Associate Specialist members from the Hywel Dda Health Board and 1 SAS vacancy. 

In order to apply for one of these posts we would like you to complete this nomination form. We advise you take a look at the Devolved Nations Boards webpage which includes information on the role and the Boards term of reference before completing this form.

Section 1: Candidate's Details
Medical grade/role (please select one)
Upload File(s)
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(Optional: please upload your basic CV via the upload facility above. It should be no more than two A4 pages, contain brief career highlights, employment history, publications, other areas of clinical interest etc with no hyperlinks. Please note it should not contain any sensitive data that is not freely available in the public domain such as home address, phone numbers, other personal details etc).
Do you have any conflicts of interest?
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Section 2: Election Statement
Why are you standing for this role and why should your peers select you to represent them?
 

Confirmation

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