Clinical Council Application Form

Thank you for your interest in becoming a member of MPHN's Clinical Council.

In this online application you will be asked to explain why you would like to be considered and to complete a skills matrix. You can also upload your resume or any other supporting documents you might like to include as part of your application.

For more information about this role, or to have a confidential discussion please contact Andrew Heap via email andrew.heap@mphn.org.au or phone 02 6923 3131 or 0447833572 .

All applications must be received by midnight on Sunday 25 May 2025.

All responses are confidential and bound by our Privacy Policy.

First Name *

Last Name

Email Address *

Which Clinical Council would be most suitable for you? *

Riverina Sector incorporating the communities of Temora, Young, Boorowa, Harden, Cootamundra, Junee, Coolamon, West Wyalong, Gundagai, Tumut, Batlow, and TumbarumbaWagga Wagga Sector – Wagga communityBorder Sector incorporating the communities of Barham, Deniliquin, Finley, Jerilderie, Berrigan, Tocumwal, Corowa, Culcairn, Henty, Holbrook, Lockhart, and UranaWestern Sector incorporating the communities of Griffith, Narrandera, Leeton, Hay, Hillston, and Lake Cargelligo

Please explain why you would like to be considered for this role? *

Please upload any supporting documents you might like to include such as a resume.

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Skills Matrix

This Skills Matrix captures what skills are among the members and help identify any skills gaps. Your completed skills matrix will be used as part of the evaluation process to ensure the right mix of skills is achieved with new members.

Instructions

For each skill, please provide a rating of between 0-3 with:
- 3 – expert skill (You have had several years where you have developed the skills as part of your career or identify as a person or as living with a person who identifies with a particular population group, making you an expert in understanding the needs and challenges of these communities. Or this is something you are currently involved in.)

2 – moderate skill (You have had 2-3 years where you have developed the skills as part of your career or identify as a person or as living with a person who identifies with a particular population group, making you an expert in understanding the needs and challenges of these communities. This may not be something you are currently involved in.)
1 – low skill (You 1 or less years where you have developed the skills as part of your career or identify as a person or as living with a person who identifies with a particular population group, making you an expert in understanding the needs and challenges of these communities. This may not be something you are currently involved in.)
0 – no experience or skill

Please note, there is no expectation you are an expert at all these skills. You are not required to be an expert in any particular area to be eligible to become a member.

Please refer to the Skills Matrix Completion Guide which is in the information pack available on our website for more information about how to complete the skills matrix.

Do you have anything you would like to add in relation to how you have scored these skills?

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