• EOI - Network Executive

    Please fill out this form to submit your Expression of Interest

  • Inclusivity

  • Expressions of interest and/or nominations that reflect the diversity of the ACEM membership are encouraged. Where applicable, appointments will be made with consideration given to the objective of ensuring this diversity is reflected in the membership of the entity.

  • What is your status at the College:*
  • In which jurisdiction are you located?*
  • Which best describes your time as a Fellow?*
  • What best describes your primary place(s) of work?*
  • Sex as listed on the Portal

  • Networks

  • Please select the Network Executive you wish to join.*

  • You are welcome to submit an Expression of Interest (EOI) for more than one network. Please note that a separate application form is required for each network.

  • Statement of Suitability

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  • Office Holders

  • Each Network Executive shall have an appointed Chair and Deputy Chair(s), who serve as the Office Holders of the Network Executive. Office Holders are appointed from the FACEM membership by the relevant governing body in line with the Policy on College Entities.

  • Are you interested in being considered for appointment to an Office Holder position?*
  • Please indicate the Office Holder position(s) you are interested in being considered for.*
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  • Core Values

  • The Core Values of respect, integrity, collaboration, and equity define the organisation's guiding principles and underpin the way ACEM works to meet its vision and mission of ensuring the highest standards are maintained in the training of emergency physicians and in the provision of emergency care to the communities of Australia and Aotearoa New Zealand.

    All appointees to ACEM roles and entities must have completed the ACEM Core Values module by the close of the applicable application process. 

  • Please confirm that you have completed the ACEM Core Values module:*

  • Please note that the module must be completed by the close of the Expressions of Interest period for your application to be considered.

  • Curriculum Vitae

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  • Conflict of Interest

  • ACEM requires all entity members to disclose any conflicts of interest (perceived or actual) in line with the Conflict of Interest Policy. Please indicate any conflicts of interest to be considered in the context of your application and potential appointment. If there are none, then please leave this field blank.

  • Declaration

  • By completing the following declaration, you acknowledge that the information that you have provided in your application is true and accurate to the best of your knowledge. Additionally, you acknowledge that your Curriculum Vitae and Supporting Statement will be made available to members of ACEM governing bodies and their delegates (as applicable) for consideration of the appointment.

  • In submitting this application, I declare that:*
  • Good standing confirmed
  • Core Values confirmed
  • Should be Empty: