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Application for membership of a Regional Advisory Committee for researchers/academics

This application form is for researchers and academics to express an interest in becoming a member of an NIHR Research for Patient Benefit (RfPB) Regional Advisory Committee.

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

Please note: Each RfPB Regional Advisory Committee can have no more than three NIHR Research Support Service (RSS) Advisors as Committee members.

If you are not a research active professional, such as a commissioner or policy maker, and would like to apply to join an RfPB committee, please use our alternative application form for non-research active individuals.

More information on how to apply is available in the guidance for applicants to committee membership positions. Please email any queries to

Applicant details

As this information will be used in official correspondence, please omit middle names and initials unless you need these to be used.

NIHR Research Support Service Advisor (required)
Contact details
Professional details and fields of research

Please categorise the experience you would offer to a Regional Advisory Committee:

Cross-cutting health science expertise: (Please tick all that apply) (required)
Health categories of specialist knowledge: (Please tick all that apply) (required)
Professional details

Please include the following information: date; qualification; class; subject; awarding body

Please give details of your accreditation with any professional bodies (including dates)

Please include the following information: dates; job title; employing authority

Please include the following information: dates; title; co-applicants; source (organisation name); start date; duration; total grant

Please list the research methodology skills you have reached a strong level of competency in (maximum 1,500 characters).

Please provide details of relevant services, research, education or user experience (maximum 1,500 characters).

Please detail any relevant experience serving on committees and/or advisory bodies (Maximum 1,500 characters).

Please detail any relevant experience serving on committees and/or advisory bodies (Maximum 1,500 characters).

Supporting information

Please explain why you are interested in becoming a Regional Advisory Committee member, and how your experience to date would help you to perform this role (Maximum 2,500 characters).

Please upload a full list of publications, with the five publications most relevant to this application marked with an asterisk (*).

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. 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.

If you require any further information or assistance, please send a brief description of your requirement to  Alternatively you can contact the RfPB Programme Management team at 020 8843 8057.