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Delegates Handbook

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MEMBER REPORT BACK<br />

Name: ..................................................................................................................................................................................................................................................................................<br />

Position: ......................................................................................................................................................................................................................<br />

Phone no: (w) ............................................................. (h)..............................................................(m)....................................................................<br />

Email: ...........................................................................................................................................................................................................................<br />

Workplace: .................................................................................................................................................................................................................<br />

Membership no: .......................................................................................................................................................................................................<br />

Date joined: ...............................................................................................................................................................................................................<br />

Financial? Yes No<br />

Issue: ............................................................................................................................................................................................................................<br />

Date: _____ /_____ /______<br />

Issue/question<br />

(Background to issue/question, date of incident, people involved, where it happened, what action the member has taken to date etc.)<br />

........................................................................................................................................................................................................................................<br />

........................................................................................................................................................................................................................................<br />

........................................................................................................................................................................................................................................<br />

........................................................................................................................................................................................................................................<br />

(Continue overleaf if needed)<br />

ACTION<br />

Action to be taken by member:..........................................................................................................................................................................<br />

Action to be taken by delegate:..........................................................................................................................................................................<br />

RESULT..........................................................................................................................................................................................................................<br />

........................................................................................................................................................................................................................................<br />

Date: _____ /_____ /______<br />

16 | <strong>Delegates</strong> <strong>Handbook</strong>

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