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Membership Application Form

NEIHR's purpose is to enable the delivery of better care and better health for our rural and regional communities through research and collaboration.

We invite you to submit your nomination for membership of the New England Institute of Healthcare Research (NEIHR).

We look forward to hearing from you!

The information provided in the application will be processed by NEIHR staff and will not be shared with other departments or external bodies. Information collected on this form will adhere to UNE’s Privacy Management Rule and Procedures. Please see UNE's Privacy Policy for more information.

Required fields are marked with an asterisk (*).

YOUR DETAILS

Your title * E.g. Prof., Dr, Mr, Ms

First name *

Last name *

Preferred email address *

Preferred contact phone number * Use numbers only and no spaces.

Postcode * Your primary residence postcode

CURRENT EMPLOYMENT AND AFFILIATION

Current role (select all that apply) * Select all that applies

Academic
Full-time researcher
Health practitioner
Health services manager
Masters or PhD student
Work in a research support role (e.g. lab manager, statitician, administration
Other

Current employment position *

QUALIFICATIONS

What are your qualifications? * (max. 250 words)

Do you have a PhD? *

The University of New England respects and acknowledges that its people, courses and facilities are built on land, and surrounded by a sense of belonging, both ancient and contemporary, of the world's oldest living culture. In doing so, UNE values and respects Indigenous knowledge systems as a vital part of the knowledge capital of Australia. We recognise the strength, resilience and capacity of the Aboriginal community and pay our respects to the Elders past, present and future.