Nominations for the Health and Safety Committee

Details: Published: 18 September 2026

Nominations for the Health and Safety Committee

Branches are invited to nominate one health and safety representative from their own branch only

to be elected to the Committee.

Forms must be submitted by: 2pm Wednesday 14 October 2026

After submission you'll receive an email confirming the details of your Branch nomination.

Please check your spam/junk folder if this is not in your inbox.

Form 1b: Nomination form

Nomination for Health and Safety Committee

I certify that the person nominated is an appointed branch health and safety representative.

Office held in Branch

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Signed(*)

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Branch Number(*)

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Email Address(*)

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*For candidates employed by Northern Ireland Civil Service please indicate General Service, Support Grade, Professional and Technical, Agricultural Inspectorate or
Scientific.

** Please specify employer e.g. NIHE, Education Authority (Belfast Region), Belfast City Council, Western Health and Social Care Trust, Libraries NI,
South Eastern Regional College, Northern Ireland Chest, Heart and Stroke, etc.

Name(*)

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*Grade(*)

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**Employer(*)

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Address of Nominee

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(*)

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