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Council member EOI form

Which Council are you applying/reapplying for? 

Contact information

Please provide your personal details below

Do you identify as

Professional qualifications

Abridged CV 

If your application is successful, the details entered here will be provided to the Minister for Health as an Abridged Curriculum Vitae. Please do not write 'refer to CV'. 

Education, qualifications and accreditations

Please include in the following order: [year graduated], [qualification title], [name of school/institution]. Please also note awards or prizes (e.g. Honours or University Medal) Example: 2021, University of Sydney, Bachelor of Arts (Honours)

Employment history 

Please enter in the following order: [month year], [job title], [organisation]. Example: June 2023, Research Officer, Macquarie University, October 2008, Project Officer, Sydney Projects

Awards, significant achievements and/or publications

Current and/or previous statutory appointments 

Please enter in the following order: [year start-year end], [Board name], [member type]

Example:2021-2024, Medical Council of NSW, community member
2022-2025, Mental Health Review Tribunal, part time lawyer member

Professional memberships

Please enter in the following order: [institution name], [year if applicable]

Example: 
Australian Institute of Company Directors, 2021
Member Royal Australasian College of Physicians

Details of two referees:

Provide details in this order:

Name:

Position:

Email address:

Phone number:

Provide details in this order:

Name:

Position:

Email address:

Phone number:

Consent and privacy

Shortlisted applicants will undergo probity checks to ensure that applicants are of good standing, which may include:

  • a national criminal history check

  • an Australian Securities and Investments Commission (ASIC) disqualification register check

  • a National Personal Insolvency Index check conducted through the Australian Financial Security Authority (AFSA) 

  • a check of the HPCA’s records to ensure that practitioner member applicants are of good standing in the profession

Results of the probity checks are reported to the Minister for Health for the purpose of considering recommended nominees’ suitability for appointment.

Do you consent to the HPCA conducting these probity checks for the above purpose? 

NSW Health Professional Councils attain the expertise of community and professional members to conduct Council work including interviews, audits, assessments and hearings. 

If you consent, NSW Health Professional Councils and HPCA support staff may access your contact details and CV.

Do you consent to the HPCA providing your contact details and CV to the NSW Health Professional Councils and HPCA support staff for consideration? 

Privacy notice

The HPCA complies with NSW government privacy policies and relevant legislation. If you are shortlisted for recommendation to the minister for appointment to a NSW health professional council, your personal information will also be provided to the Ministry of Health, Corporate Governance and Risk Management Unit, for the purpose of seeking approval of your appointment. Your personal information will be recorded in the ‘GOView database’ which is managed by The Cabinet Office.  

The Ministry’s privacy notice is available here:  

Privacy notice pdf


Have you read the Ministry of Health privacy notice?

Selection criteria

Please address each of the following selection criteria (max 500 words per selection criteria)  

High level of expertise or experience in one or more of the following areas: 

  • community engagement/representation 

  • consumer rights in health

  • current involvement in tertiary education, governance, ethics or research

  • a registered medical practitioner or a previous registered medical practitioner.

The capacity to actively participate as a member of council in the regulation of registered health practitioners to protect the public including evidence of integrity, independence, impartiality, good judgement, and social awareness. 

High level of oral, written, and interpersonal communication skills including influencing and negotiating. 

Demonstrated experience or capacity to work collaboratively and productively as a member of Council. 

Expression of interest and CV