Thank you for expressing your interest in the Appointment of a Panel to sustain Victims and Survivors Forum Membership 2016-2019.

In order to engage effectively with Victims and Survivors in a competent and ethical manner, the Commission for Victims and Survivors are seeking to appoint a panel of Victims or Survivors in order to:

1. Complement and assist in the work of the Commission by creating a wider advisory body of Victims and Survivors for accessible and broader consultation; and
2. To replenish the membership of the Victims and Survivors Forum.

This Panel will be appointed for the period June 2016 - September 2019, to run in line with the Commissioner’s term of office.

To be on the Panel, you must meet the definition of a Victim or Survivor as set out by the Victims and Survivors Order (NI) 2006:

(a) Someone who is or has been physically or psychologically injured as a result of or in consequence of a conflict-related incident;

      • an individual may be psychologically injured as a result of or in consequence of witnessing a conflict-related incident or the consequences of such an incident; or
      • Providing medical or other emergency assistance to an individual in connection with a conflict-related incident.

(b) Someone who provides a substantial amount of care on a regular basis for an individual mentioned in paragraph (a) above.

(c) Someone who has been bereaved as a result of or in consequence of a conflict-related incident.

The NI Victims and Survivors Order 2006 defines a ‘conflict-related incident’ as an incident appearing to the Commissioner to be a violent incident occurring in or after 1966 in connection with the affairs of Northern Ireland.
In order to progress with this expression of interest form, can you please confirm:

The definition of a victim and survivor applies to me:
Please select ONE only.