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NI Webform - Branch nomination form

Branch post nomination form

1. Branch: *This question is required.

2. Name: *This question is required.

3. Address: *This question is required.

4. Telephone number: This question requires a valid number format.

5. Email: This question requires a valid email address.

6. Job title:

7. Workplace:

8. Gender: *This question is required.

9. Work pattern: *This question is required.

10. What branch post are you applying for?

11. Other branch post (please specify):

While all core posts can be job shared to ensure proportional representation of women, Regional posts must be nominated on a strict proportion bases ie: 2 posts - minimum 1 woman 3 posts - minimum 2 women.

Note - all candidates must be nominated and seconded by two fully paid up branch members.

12. Nominated and seconded by: *This question is required.

13. Nominated and seconded: *This question is required.

14. Please sign and date your submission: *This question is required.

Signed:
Dated: