Page 1 - DRSG4 Application form

DRSG4 Application form

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Please select your title.

Please enter your personal details below:

First name:

Surname:

Please enter your email address below.

Name of the University or hospital or clinical practice you are primarily employed in:

What part of the UK do you currently reside in?

Do you currently volunteer with Diabetes UK?

No

Yes (please specify):

This is required

Which role in the DRSG are you applying for?

Please note: We are looking for people with a special interest in acute diabetes or inpatient diabetes.

Researcher

Consultant or Associate Specialist

Allied healthcare professional, including nurses and dieticians

Doctor in training or allied healthcare professional in training (for associate membership of the group)

Do you have any unspent convictions?

If you would like to talk with someone about this before applying, please contact the Safeguarding team at safeguarding@diabetes.org.uk or telephone 0207 424 2205. Please note that a conviction will not necessarily exclude you from volunteering with Diabetes UK but will be taken into account when assessing your suitability. Some volunteer roles will require you to complete a Data Barring Service check, DBS (England and Wales) / PVG (Scotland) / ANI (Northern Ireland).

No

Yes (please specify):

This is required

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