| SAINT LUCIA |
| BETWEEN: |
| Appellant |
| And |
| Respondent |
| APPLICATION TO EXTEND TIME WITHIN WHICH TO APPEAL |
| Take notice that |
| (1) , a health |
| practitioner/an applicant for registration under the Act who is aggrieved by the relevant Council, |
| (2) intends to apply to the Appeals Board to extend the time within which |
| he/she may appeal against the decision of the relevant Council dated the day |
| of 20 of which he/she received notice on the |
| day of 20 |
| (3) And further take Notice that the reasons for this application are as follows— |
| (a) |
| (b) |
| (c) |
| (d) |
| (4) And further take notice that the reasons for which he/she desire to appeal against the said decision are as follows— |
| (a) |
| (b) |
| (c) |
| (d) |
| And further take notice that the decision he/she seeks is |
| (a) |
| (b) |
| (c) |
| (d) |
| All notices or other documents relating to this application may be sent to the Appellant at |
| (5) |
| |
| Dated this day of 20 |
| |
| Appellant/Legal practitioner |
| To: | The Secretary |
| The Appeals Board |
| Note: |
| (1) Name of appellant |
| (2) Relevant Council |
| (3) Insert reasons for delay |
| (4) Reasons for Appeal |
| (5) Addresses |