Trainees' Committee nomination form

Please note that the information provided in the questions marked with an asterisk * will be seen by eligible voters.

Full name *

RCOG account number

Email address

Region

Pre- or post-MRCOG

Pre-MRCOG
Post-MRCOG

Specialty training year *

Current appointment *

Professional activities, interests, RCOG commitments (100 words maximum) *

Please provide a brief statement why you are applying for this post? (100 words maximum) *

First nominator's name and RCOG number

Second nominator's name and RCOG number