Hospital and Health Boards

To view the Application Pack please click here.

This form is to be used for individuals applying for appointment to a government body within the health portfolio. The information is sought to assist in assessing your eligibility and suitability for nomination and/or appointment.

To apply you must:
• complete this form
• provide a Curriculum Vitae (maximum 2 pages)
• address any additional requirements detailed in the application for the role you are applying for (e.g. a personal statement addressing selection criteria if requested).

Your personal information will be treated as confidential and will only be accessed by authorised persons and, should you be successful in the appointment, to ensure an accurate record of nominees and appointees to statutory bodies.

Personal information collected by the Department of Health is handled in accordance with the Information Privacy Act 2009. The personal information provided by you will be securely stored and made available only to appropriately authorised officers. Personal information recorded on this form will not be disclosed to other parties without your consent unless required by law.

Personal information may be disclosed as part of the recruitment process, for example, in contacting referees or obtaining certification of public sector employee nominees.