Committee membership application

Committee Membership Application Form

NIHR is committed to a supportive, inclusive, and positive community. Equality, diversity and inclusion are fundamental to our values and vital to our success. We are currently looking to diversify and enrich our committees. We particularly welcome applications from disabled candidates and candidates from an ethnic minority background as they are currently under-represented.

For longer answers, you can drag the bottom right-hand corner of a text-entry field to expand the size. If you have any other queries about how to fill out this form, please do not hesitate to contact us at netsagmembership@nihr.ac.uk

Section 1

Role/s for which you wish to be considered

Role A

Role reference number (required)

Role title (required)

Role B (optional)

Role B reference number

Role B title

Section 2

Contact details

Title (required)

First name (required)

Middle names

Surname (required)

Suffix

Primary (work) details

Job title (required)

Primary specialty (required)

Department / school

Organisation (required)

Type of affiliation

Address (required)

Town / City (required)

County

Postcode (required)

Country (required)

Email Address (required)

Telephone number (required)

Web address (please include the full link, e.g. https://www.google.co.uk)

Other affiliated organisations and contact details

Other organisations and details

Section 3

Professional Details

3a. Summary

Please summarise your knowledge, skills and experience using up to five key words or phrases (such as service management, health economics, questionnaire design, paediatrics, obesity etc.) in the spaces below. The words you provide should summarise your content knowledge as well as any relevant research methods expertise.

1 (required)

2 (required)

3 (required)

3b. Research methodology skills

If applicable, please list the research methodology skills in which you have reached a strong level of competency. (Maximum 2000 characters).

Research methodology skills

3c. Knowledge, skills and experience

Please detail your specialist knowledge, skills and experience and how they demonstrate your suitability for an NIHR Committee role, what you hope to bring to the role, and why you wish to become a committee member referring to the criteria in the person specification (see guidance notes). (Maximum 5000 characters)

Knowledge, skills and experience (required)

3d. Additional question for applicants to any HTA Funding Committee

Experience of reviewing for the HTA programme is a requirement when applying for membership of any HTA funding committee. Please detail your HTA reviewing experience if applicable. (Maximum 5000 characters)

HTA experience

Section 4

4a. Current or previous memberships

Please provide details of any current or expired committee membership for the NIHR or other research funders within the last 3 years. (Maximum 5000 characters)

Please note members may not serve on more than one NIHR committee simultaneously. A maximum overlap of one meeting of each prioritisation or funding committee is permitted

Current or previous memberships

4b. Other applications

Have you recently applied for any committee positions with other funders which may affect your ability to take a role if offered?

Other applications

If yes, please give details where possible (Maximum 2000 characters)

Other application details

Section 5

Getting involved in reviewing

From time to time we invite people with relevant knowledge and expertise to undertake reviews for NIHR programmes on the content of short briefing papers, proposals for research, and final reports of research findings.

If you would like to join the NIHR Reviewer Community, please tick here:

Yes I would like to join the NIHR Reviewer Community

Section 6

Please tell us how you heard about our committee membership opportunities

If other please specify

Section 7

Supporting documents

Please upload any supporting documentation. Hold down Ctrl to select multiple documents.

Supporting documents

By completing this form you are agreeing to your details being added to our management Information System (MIS) and REsearch Awards Lifecycle Management System (REALMS) databases. Your personal information is held and used in compliance with the General Data Protection Regulation 2016 (GDPR) and the Data Protection Act (2018). The Department of Health and Social Care, NIHR is the Data Controller under GDPR. Under GDPR, we have a legal duty to protect any information we collect from you.

You should be aware that information given to us might be shared with other DHSC NIHR bodies for the purposes of statistical analysis and other DHSC NIHR management purposes. We also reserve the right to share details of research applications with other approved research funding organisations outside the NIHR in order to coordinate research activity in the UK. Information collected from you will not be passed to any third party outside the NIHR except specifically as detailed above without your consent except where we are under a statutory obligation or entitled to do so by law. Applicants may be assured that DHSC NIHR is committed to protecting privacy and to processing all personal information in a manner that meets the requirements of GDPR. You can ask for your details to be removed from our database at any time by emailing us.

View the NIHR Privacy Policy

PLEASE NOTE: If your application fails to submit, you will need to re-attach your files and re-select any checkboxes.

Please confirm the following before pressing the submit button

I have attached my CV (required)

I have read and understood the data protection statement and I agree to my personal information being used as described above (required)

To help us verify genuine submissions please answer the following question: What is two plus zero? (required)