Application for Urine Infection training
Name of Applicant: (Print)…………………………………………………………………………
Job title ……………………………………………………………………………………..
Company/Home/Organisation name and postcode……………………………………………
Contact number ………….………………………………………………………………………..
Email address for correspondence………………………………………………………………
Name of supporting manager (Print)……………………………………………………………
______
I wish to apply for a place on the urine infection training session, (please refer to the attached timetable of dates and venues on the next page)
1st choice date/venue
2nd choice date/venue
Signature of applicant…………………………………………………………
Date:……………...
*I confirm that on behalf of the company/organisation named above, that I agree to pay on invoice, the sum of £100 to Bromley CCG, for non-attendance of the applicant at the confirmed training session, without prior notice of at least 48 hours
Signature of supporting manager………………………………………………………… Date:…………..…
______
Each training session is approximately 2.5 - 3 hours. The training is provided free to attendees from organisations/companies that provide care to Bromley residents.
Confirmation dates will be sent via email within 1 week of the application receipt.
______
Please return your completed form (Page 1 only) by email to [email protected] or by fax 01689880950
For all enquiries please ring the ProMISE team at Bromley CCG tele:01689880583
Page 1 of 3 Dates and venues for Urine Infection training
August:
Monday 12th 13:30 – 16:30 Boardroom, Bassetts House
Friday 16th 13:30 – 16:30 Muirhead Room, Beckenham Beacon
Monday 19th 09:30 – 12:30 Muirhead Room, Beckenham Beacon
Friday 30th 13:30 – 16:30 Boardroom, Bassetts House
September:
Monday 2nd 09:30 - 12:30 Committee Room 1, Civic Centre
Friday 6th 13:30 – 16:30 Muirhead Room, Beckenham Beacon
Monday 9th 13:30 – 16:30 Boardroom, Bassetts House
Tuesday 10th 09:30 – 12:30 Training Room, Bridges Healthcare
Friday 13th 13:30 - 16:30 Committee Room 2, Civic Centre
Monday 16th 13:30 - 16:30 Committee Room 1, Civic Centre
Friday 20th 13:30 – 16:30 Muirhead Room, Beckenham Beacon
Monday 23rd 14:00 – 17:00 Boardroom, Bassetts House
Friday 27th 09:30 - 12:30 Boardroom, Bassetts House
October:
Tuesday 1st 09:30 – 12:30 Boardroom, Bassetts House
Tuesday 8th 13:30 - 16:30 Boardroom, Bassetts House
Tuesday 15th 09:00- 13:00 Boardroom, Bassetts House
Monday 28th 09:30 – 13:30 Muirhead Room, Beckenham Beacon
Please note there are only 15 places available per session.
Bassetts House, Broadwater Gardens, Orpington, Kent, BR6 7UA
Muirhead Room, Beckenham Beacon, 379 Croydon Road, Beckenham BR3 3FD
Committee Rooms, Civic Centre, Stockwell Close, Bromley BR1 3UH
Bridges Healthcare, Wells House, 3rd Floor, 15 Elmfield Road, Bromley BR1 1LT
Page 2 of 3 Page 3 of 3