Before submitting this form please ensure you have read all the course information. Please note we cannot guarantee a place on our limited centrally run courses. You will be added to a waiting list and we will contact you when a place becomes available on your chosen course.

Alternatively, please link in with your local trusts and engagement networks as we encourage organisations to link up to commission their own course.

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* Full name

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* Job title

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* Organisation

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* Email address

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* Phone number

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* Colleague full name

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* Colleague job title

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* Colleague organisation

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* Colleague contact email

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* Colleague contact number

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* I confirm I have read the course information and understand that my submitted details will be held securely on a waiting list until a course place becomes available.

Data protection
All information provided through this survey will be held by the NHS Confederation. The information collected will be processed via SurveyMonkey, on behalf of the NHS Confederation and shared within the NHS Confederation but will not be shared with any other third parties. Please see our privacy policy for further information on how we will handle your data and you may opt out from communications from us at any time.

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