Personal and Contact Details

In order to apply to become an MFSRH External Examiner please complete the following form. Your application will then be submitted for review by the FSRH Education and Training team. 

Please read the MFSRH External Examiner role description before applying. 

Closing date for applications - Wednesday 1 April 2020. However, this application process may close sooner depending on the number of applications received. 

By completing and submitting the following form you are consenting for FSRH to view and store the information provided for the purpose of considering your application for approval and to share this with the relevant FSRH officers and committees. For more information please see the FSRH privacy and data protection policy here

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* 1. Full Name

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* 2. Home Address

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* 3. Work Address

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* 4. Region

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* 5. Home Telephone

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* 6. Mobile

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* 7. Work E-mail Address 

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* 8. Home E-mail Address

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