i4i Committee Expression of Interest Form

Please note: No individual should be a standing member of more than one NIHR Research Programme Funding Committee at one time, other than in very exceptional circumstances when no other person is available to cover the role. Those people who are involved in awarding NIHR Research Training and Leadership Programme funding (NIHR Academy Programmes) can also be a member of an NIHR Research Programme Funding Committee so that they have insight into the research pathway.

This expression of interest form is for clinical, academic or commercial experts to express an interest in becoming a member of an NIHR Invention for Innovation (i4i) funding Committee.

When a vacancy on a funding Committee becomes available, your application will be considered. If no vacancy becomes available, your application form and its data will be retained for five years. Please bear in mind that funding Committees must have a balanced range of skills and expertise, and new members will be appointed as and when particular gaps emerge.

Please email any queries to i4i@nihr.ac.uk.

Contact details

Title (required)

Surname (required)

Forename (required)

Employing organisation (required)

Current/last job title (required)

Email Address (required)

Region where you are currently based (required)

Professional details

Degrees and other qualifications. Please include the following information: date; qualification; class; subject; awarding body

Present and previous positions held. Please give job title, employing organisation, employment dates and responsibilities for previous roles

Work on committees and in an advisory capacity. Please detail any relevant experience serving on committees and/or advisory bodies

Supporting information

Please let us know how you heard about the opportunity to apply to be a member of an i4i Funding Committee

Please explain why you are interested in becoming an i4i funding Committee member, and how your experience to date would help you to perform this role (maximum 2,500 characters)

If you selected other please provide further information

Use of your personal information

Please note that the details provided in this application form are covered by the NIHR Privacy Policy.

By completing this form you are agreeing to your details being added to our database.
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. 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 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.

If you require any further information or assistance, please send a brief description of your requirement to i4i@nihr.ac.uk or contact the i4i Programme Management team at 020 8843 8080.

I have read and understood the data protection statement (required)