Course Request Form

Please only use this form if you are an employee working in Primary Care in Wandsworth and would like to make a request for personal or professional development.

Requests are reviewed every two months, by the Wandsworth Training Hub Education Committee.

Please remember to check out our upcoming training schedule to see what's on offer.

Thank you,
The Wandsworth Training Hub
wandsworthtraininghub.com

swlicb.training@nhs.net

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* 1. Your details.

Name

Job Title

Email Address

Phone Number

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* 2. Name of course or training programme requested.

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* 3. What new skills do you hope to gain from this course or training programme?

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* 4. Name of provider (company) delivering the course or training programme.

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* 5. Your main primary care employer details.

Employer Name

Employer Address

Days (sessions) per week worked?

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* 6. Is the course or training programme accredited?

Yes

Unsure

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* 7. How long is the course or training programme?

One or two hours

Half day

Full day

Multiple days

Other

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* 8. How much does this course or training programme cost?

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* 9. Please confirm whether this course is currently supported by your line manager or employer?

Yes

Don’t know

If 'Yes', is funding currently being contributed by yourself or your employer?

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* 10. How much funding are you requesting for this course or programme?

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* 11. Declaration

I am aware my details will be processed by the Wandsworth Training Hub in order to facilitate a response to this request. Data will be processed in accordance with our Privacy Notice, which can be accessed here.

I understand that I may occasionally be required to provide feedback on this process, to support evaluation.

I understand that this course request does not guarantee the provision of funding for named course or training programme.