Application form for Advisory Group Member

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Referees
Complete

Forename

Surname

Home address including postcode

Email address

Telephone number

Why would you like to join Healthwatch Rochdale Advisory Group

What skills and exp could you bring to this role – please refer to the role specification.

What experience, either employed or voluntary, do you have of the local health and social care services within the Rochdale borough?

How / where did you hear about the role of an Advisory Group member with Healthwatch Rochdale?

Do you have any business or personal interests that might be relevant to the work of Healthwatch Rochdale which could lead to a real or perceived conflict of interests were you to be appointed? (Failure to disclose such information could result in an application being terminated).

Yes