0131 527 1612
Which position are you seeking nomination for?
Your proposer and seconder are asked to email email@example.com independently to confirm their support of this nomination
Proposer's Membership Number
Seconder's Membership Number
Main Professional Appointment
Please limit your responses to the following questions to 150 words in total (e.g. 75 words each). These responses will not be edited.
Please outline clearly any duties you currently undertake both on behalf of the Faculty and for Sport and Exercise Medicine in general
Please outline your aspirations for the future regarding involvement with the Faculty
By submitting this nomination, I declare that I have not, in the UK or outside:
• Been convicted of a criminal offence (including any spent convictions) or have proceedings pending against me.
• Had any cases adversely considered by the GMC, other professional regulatory body, or other licensing body or have any such cases pending against me.
• Had any disciplinary actions taken against me by an employer or contractor or have had any contract terminated or suspended on grounds relating to my fitness to practice
I agree to the above declaration
Excellence in Musculoskeletal Medicine, Exercise Medicine and Team Care
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The Faculty of Sport
and Exercise Medicine
6 Hill Square
Tel: 0131 527 1612
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