ࡱ> 796 cbjbjss *c////   r9  99//9.//9/]+g0   | >H,t$   }   9999           :  Somerset Local Medical Committee iGPCC Election 2011 SESSIONAL GP FEDERATION DECLARATION FORM Please return this form by no later than Noon on Monday 18th April 2011 Sessional GPs on the Somerset Medical Performers List, or who are on another List but predominantly work in Somerset, are eligible to both stand and vote in the election of a GP delegate from one Somerset GP Federation area to the interim GP Commissioning Consortium for Somerset. If you would like to vote in the election but are neither a partner nor an employee of a particular practice, please can you complete and return the declaration below. We will send you a voting paper on receipt of this completed form Date ......................... Name. Correspondence Address....................................................................................................... Preferred Email.. Postcode ........................................ I am on the Somerset Performers List or I am not on the Somerset Performers List but work predominantly in the county Please delete whichever does not apply And I wish to vote in Federation area Signed.. You can return this form by folding it and posting to the address below, by fax to 01823 338561, or as an email attached .tif document to  HYPERLINK "mailto:lmcoffice@somerset.nhs.uk" lmcoffice@somerset.nhs.uk Jill Hellens Returning Officer, iGPCC Election Somerset Local Medical Committee Crown Medical Centre Venture Way Taunton TA2 8QY /BDFGqr 2 3 { | sjf[S[K[K[K[K[hCJaJhdCJaJh@h@CJaJhhK.hp15CJaJhhK.hhK.5CJH*aJhhK.5CJaJ h|CK5CJ hhK.5CJ#h@h@5CJOJQJ^JaJ h|CK5CJhhK.hhK.5CJOJQJ^JhhK.h|CK5CJOJQJ^J"hhK.hhK.5>*CJOJQJ^JhhK.h|CK5CJOJQJ^Jh|CKjh|CKU#/EFGqr   dhgdhK. f f` \ U &#$+D/U &#$+D/ %9&#$/ e    '  5 6 {  բ՗北Մ{{tllh3CJaJ h35CJh@6CJaJhhK.CJaJh@h|CKCJaJh@hhK.CJaJh|CKCJaJh@hCJaJh@h3CJaJhdhd5CJaJhd5CJaJh@CJaJhdCJaJhCJaJh@h@CJaJhm|CJaJ&   6 9 /EQc f f /CEPQbcŻŻŻ h|CKCJ h D5 h35 h|CK5 h|CKCJ hm|CJhCJaJh Wh30JCJaJh3CJaJjh3CJUaJ(. 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