1 Start 2 Complete Name * Address * Telephone Number Email Job Title Workplace Gender * Male Female Other Job Pattern * Full Time Part Time Signed * Date * Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year20222023202420252026 Nominated Post * Branch Chair Branch Secretary Joint Branch Treasurer Education Coordinator Union Learning Rep Equality Officer Women Equality Officer LGBT+ Equality Officer Black and Migrant Workers Equality Officer Disability Health and Safety Officer Communication Officer International Officer Young Members Officer Welfare Officer Membership Officer While all core posts can be job shared to ensure proportional representation of women, Regional posts must be nominated on a strict proportion bases ie: 2 posts - minimum 1 woman 3 posts - minimum 2 women Nominated and Seconded * All candidates must be nominated and seconded by two fully paid up branch members. Nominated and Seconded * All candidates must be nominated and seconded by two fully paid up branch members. Leave this field blank