I confirm that the information contained in this application is correct. Signature: Date: This role will require line manager support for a minimum of 1 day per month, and has a 3 year term. Please ensure your line manager has signed this form indicating their support to undertake the role. Name of line manager: Role: Signature: Date: Organisation: Once completed please return this form to: Lockwood E: Completed application forms must be received by Tuesday 3 January 2017
I confirm that the information contained in this application is correct. Signature: Date: This role will require line manager support for a minimum of 1 day per month, and has a 3 year term. Please ensure your line manager has signed this form indicating their support to undertake the role. Name of line manager: Role: Signature: Date: Organisation: Once completed please return this form to: Lockwood E: Completed application forms must be received by Tuesday 3 January 2017
Chairpersons_Application_form_Chief_Nursing_Officer_BME_Strategic_Advisory_Group.docx