Formic Web Forms - [Cohort 3 and 4 NHS Demand and Capacity Management course

Cohort 3 and 4 NHS Demand and Capacity Management course

Employer name:

YOUR DETAILS

COHORT 3 & 4

Gender:

APPLICATION QUESTIONNAIRE
DEMAND & CAPACITY TRAINER PROGRAMME

COHORT 3 & 4

Employer postcode:

Last name:

Page 1 of 3

Date of birth:

Job Title:

Employer address:

Mobile number:

Postal address:

For each cohort, students will be divided into two groups. You must be able to attend all of the mandatory training dates for a specific group.
These dates, as well as the location of these courses, can be found on the associated PDF file available on www.elsbusinesstraining.co.uk/certified-courses/nhs-course/

Cohort 3
Application closes: 5 Feb 18
Course location: Birmingham
Course Dates: Mar - Aug 18

Salutation:

I understand that the programme is a continuing process. I confirm I am available to attend all selected mandatory training dates and complete all selected mandatory online training and course assignments, as set out in the learner's contract.

Please select the trust you work for from the options in the drop-down menu:

The personal details requested are required to Register you with the Institute of Leadership and Management (ILM) and for contact purposes by both ELS and the NHS to inform you of your selection for the course. By completing this area with your details, you are consenting to ELS using these details to register you with the ILM (for certification requirement), for contact purposes and that your personal information will not be used for any other purpose. Personal data collected will be managed in accordance with ELS 030. Data Protection Policy (of which can be provided on request).

Cohort 4
Application closes: 5 Feb 18
Course location: London & Peterborough
Course Dates: Mar - Sep 18

First name:

Email address:

I work for none of the above organisations, and will provide details of my employer including name, address and postcode.

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Female

Male

Cohort 4 Group B

Available for all Cohorts/groups

Cohort 3 Group A

Cohort 3 Group B

Please select from below the groups that you are available for:
Please tick all that apply

Cohort 4 Group A

Basildon and Thurrock University Hospitals NHS FT

Bedford Hospital NHS Trust

Birmingham and Solihull NHS FT

Birmingham Children's Hospital NHS FT

Birmingham Community Healthcare NHS Trust

Birmingham Women's Hospital NHS FT

Black Country Partnership NHS FT

Burton Hospitals NHS Ft

Cambridge and Peterborough NHS FT

Cambridge University Hospital NHS FT

Cambridgeshire Community Services NHS Trust

Chesterfield Royal Hospital NHS FT

Colchester Hospital University NHS FT

Coventry and Warwickshire Partnership NHS Trust

Derby Teaching Hospitals NHS FT

Derbyshire Community Health Services

Derbyshire Healthcare NHS FT

Dudley and Walsall Mental Health Partnership NHS Trust

Dudley Group NHS FT

East and North Hertfordshire NHS Trust

East Midlands Ambulance Service NHS Trust

East of England Ambulance NHS Trust

Essex Partnership University FT

George Eliot Hospital NHS Trust

Heart of England NHS FT

Hertfordshire Community NHS Trust

Hertfordshire Partnership University Hospital NHS FT

Ipswich Hospital NHS Trust

James Paget University Hospital NHS FT

Kettering General Hospital NHS FT

Leicestershire Partnership NHS Trust

Lincolnshire Community Hospitals NHS Trust

Lincolnshire Partnership NHS FTThe Point, Lions Way

Luton and Dunstable University Hosp NHS FT

Mid Essex Hospital Services NHS Trust

Milton Keynes University Hosp NHS FT

Norfolk and Norwich University Hosp NHS FT

Norfolk and Suffolk NHS FT

Norfolk Community Health and Care NHS Trust

North Staffordshire Combined Healthcare NHS Trust

North West Anglia Foundation Trust

Northampton General Hospital NHS Trust

Northamptonshire Healthcare NHS FT

Nottingham University Hospitals NHS Trust

Nottinghamshire Healthcare NHS FT

Papworth Hospital NHS FT

Queen Elizabeth Hospital Kings Lynn NHS FT

Robert Jones and Agnes Hunt NHS FT

Royal Orthopaedic Hospital NHS FT

Sandwell and West Birmingham Hospitals NHS Trust

Sherwood Forest Hospital NHS FT

Shropshire Community Health NHS Trust

South Staffordshire and Shropshire Healthcare NHS FT

South Warwickshire NHS FT

Southend University Hospitals NHS FT

Staffordshire and Stoke-on-Trent NHS Partnership Trust

The Princess Alexandra Hospital NHS Trust

The Royal Wolverhampton NHS Trust

United Lincolnshire Hospitals NHS Trust

University Hospital of North Midlands NHS Trust

University Hospitals Coventry and Warwickshire NHS Trust

University Hospitals of Birmingham NHS FT

University Hospitals of Leicester NHS Trust

Walsall Healthcare NHS Trust

West Hertfordshire Hospitals NHS Trust

West Midlands Ambulance Service NHS FT

West Suffolk Hospitals NHS FT

Worcestershire Acute Hospitals NHS Trust

Worcestershire Health and Care NHS Trust

Wye Valley NHS Trust

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Miss