Head and Neck Cancer Support Network
Member's Registration and Nomination Form
As part of our legal responsibilities each year we need at least 15 Network members to register. As you do this you have the opportunity to nominate members for the roles of Chair, Secretary and Board members. You will be able to vote on those nominations before the Annual General Meeting in June 2021. This year the AGM is delayed due to the Covid19 Level 4 restrictions.
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Email *
Your Name (Preferred Name, Family Name)
Information required under the Incorporated Societies Act 1908
The Incorporated Societies Act 1908 requires members to give their name and address for verification purposes. This information will be secured, and not used for any other purpose than to form a register of members.
Address
Nomination for Chair of the Network
Nomination for Secretary of the Network
Nomination for Board member (you can nominate more that one person)
Thank you!
On behalf of the Head and Neck Cancer Support Network I thank you for taking the time to support our Network.
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