Application Form - Online Theory Assessment Working Group

Thank you for your interest in becoming the Lead or a group member of the Online Theory Assessment Working Group, in order to consider and respond to your application please provide us with some further information about you on this form. We'll be in touch soon after you submit.

If you would like a copy of your responses (which can be useful, should you apply for other things in the future), please add your email address in the relevant field at the bottom of this form.

The information you have shared on this form will be used by the relevant FSRH Committee and FSRH staff for the purposes of administration only. FSRH will keep this information securely on our systems. Our full privacy policy can be viewed here.

Download the role description for the lead of the OTA.

Download the role description for the group members of the OTA.

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Your Details

Please tell us some information about how to contact you, it will only be used for the purpose of contacting you about your application on this form.

Your full name (first and surname)*

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Your main email address (we will use this to contact you about this application)*

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Your GMC/NMC number*

Some information about your qualifications*

Tell us some more about your professional experience in SRH

We would like to know a little more about any research, educational or clinical experience that will help support your application.

Your clinical experience*

Your educational activities*

Your administrative experience*

Your research activities*

Your editorial activities*

Your previous experience of writing exam questions:*

Tell us about educational experience and any other relevant information that you might have from previous roles.

Which position are your applying for?*

Lead for the online theory assessment working group
Member of the online theory assessment working group

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Application Form - Online Theory Assessment Working Group

Thank you for your interest in becoming the Lead or a group member of the Online Theory Assessment Working Group, in order to consider and respond to your application please provide us with some further information about you on this form. We'll be in touch soon after you submit.