ICS Liaison Group Member Bio and Training Needs - Page 1 of 4 - NI Direct

Personal Details

1. Name

Name (Required)

2. Email Address

Email (Required)

3. Telephone Number (if happy to share)

Number

4. For the purposes of building relationships within the group and peer support, are you happy that your email address is visible to other members of the ICS Liaison Group? This will only be used for purposes relating to the ICS Liaison Group.

(Required) Yes No

5. Which AIPB are you a member of?

(Required) Belfast Northern South Eastern Southern Western