Booking Form - Advanced, progressive disease - management and supportive strategies - HE6 (Validated by the University of Bolton)

  • Cost: Dates and cost to be advised
  • Duration: 15 week module - 5 taught days in first 10 weeks, 3 practice placements arranged by the student within the 15 week period

Correspondance Address

Title:

First Name:

Surname:

Email:

Telephone:

House & Street

Town / City

County

Country

Postcode

Health Care Trust:

Workplace:

Job Title:

Dietary Requirements*: eg vegetarian, vegan, dairy free

Invoicing Address*

*If you need to pass this form to your finance dept, please submit to us now to reserve your place and print a copy to pass to your employer

Title:

First Name:

Surname:

House & Street

Town / City

County

Country

Postcode

Can we contact you with details of courses, events & other CHE internal marketing?

What areas are of interest to you*?

*we narrowcast - We contact interested parties from time to time via email. Emails are sent based upon your areas of interest and not to every contact, telling us what you are interested in means we will only contact you with information that is directly relevant to you.

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DIPLOMA COURSE:

EVENING SEMINARS:

STUDY DAYS :

GROUPS:

Please complete the application and include a cheque payable to:

Cheshire Hospices Education, Queensway, Winsford, Cheshire, CW7 1BH

or complete the invoicing details above.

A place will be reserved for you on receipt of this booking form unless you hear otherwise. A programme and directions will be sent to you two weeks before the event. Places cancelled less than 24 hours before the study day will incur a £15 administration fee. Non-attendance on the day without prior notification will be charged the full course rate. However, if you are unable to attend your place may be transferred to a colleague. For 'free' course places non-attendance without prior notification or cancellation within 24 hours will incur a £15 administration charge.

Data Protection
Cheshire Hospices Education is registered under the data protection act. It may be necessary on occasions to share information with other educational establishments when this is course related. Cheshire Hospices Education does not pass personal data to other organisations, but may wish to keep you informed of educational news and activities



 

About Cheshire Hospice Education

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