<p> Application for Urine Infection training</p><p>Name of Applicant: (Print)…………………………………………………………………………</p><p>Job title …………………………………………………………………………………….. </p><p>Company/Home/Organisation name and postcode……………………………………………</p><p>Contact number ………….………………………………………………………………………..</p><p>Email address for correspondence………………………………………………………………</p><p>Name of supporting manager (Print)……………………………………………………………</p><p>______</p><p>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) </p><p>1st choice date/venue</p><p>2nd choice date/venue</p><p>Signature of applicant…………………………………………………………</p><p>Date:……………...</p><p>*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 </p><p>Signature of supporting manager………………………………………………………… Date:…………..…</p><p>______</p><p>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.</p><p>Confirmation dates will be sent via email within 1 week of the application receipt.</p><p>______</p><p>Please return your completed form (Page 1 only) by email to [email protected] or by fax 01689880950</p><p>For all enquiries please ring the ProMISE team at Bromley CCG tele:01689880583</p><p>Page 1 of 3 Dates and venues for Urine Infection training</p><p>August:</p><p> Monday 12th 13:30 – 16:30 Boardroom, Bassetts House</p><p> Friday 16th 13:30 – 16:30 Muirhead Room, Beckenham Beacon</p><p> Monday 19th 09:30 – 12:30 Muirhead Room, Beckenham Beacon</p><p> Friday 30th 13:30 – 16:30 Boardroom, Bassetts House</p><p>September:</p><p> Monday 2nd 09:30 - 12:30 Committee Room 1, Civic Centre</p><p> Friday 6th 13:30 – 16:30 Muirhead Room, Beckenham Beacon</p><p> Monday 9th 13:30 – 16:30 Boardroom, Bassetts House</p><p> Tuesday 10th 09:30 – 12:30 Training Room, Bridges Healthcare</p><p> Friday 13th 13:30 - 16:30 Committee Room 2, Civic Centre</p><p> Monday 16th 13:30 - 16:30 Committee Room 1, Civic Centre</p><p> Friday 20th 13:30 – 16:30 Muirhead Room, Beckenham Beacon</p><p> Monday 23rd 14:00 – 17:00 Boardroom, Bassetts House</p><p> Friday 27th 09:30 - 12:30 Boardroom, Bassetts House</p><p>October:</p><p> Tuesday 1st 09:30 – 12:30 Boardroom, Bassetts House</p><p> Tuesday 8th 13:30 - 16:30 Boardroom, Bassetts House</p><p> Tuesday 15th 09:00- 13:00 Boardroom, Bassetts House</p><p> Monday 28th 09:30 – 13:30 Muirhead Room, Beckenham Beacon</p><p>Please note there are only 15 places available per session.</p><p>Bassetts House, Broadwater Gardens, Orpington, Kent, BR6 7UA</p><p>Muirhead Room, Beckenham Beacon, 379 Croydon Road, Beckenham BR3 3FD</p><p>Committee Rooms, Civic Centre, Stockwell Close, Bromley BR1 3UH</p><p>Bridges Healthcare, Wells House, 3rd Floor, 15 Elmfield Road, Bromley BR1 1LT</p><p>Page 2 of 3 Page 3 of 3</p>