CPD Nursing - request for funding

About this form

Please use this form to request funding for individual CPD training that's coming up as well as for training you've already undertaken and/or paid for (and you are just looking to be reimbursed).

Once submitted, this request will be reviewed by the NCL Training Hub and the relevant borough nurse lead.

NB This form is to be used by general practice nurses and paramedics currently employed in a North Central London primary care setting ONLY.

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* 1. Your details

Your name and surname

Practice/organisation

Borough

PCN

Your role

Email Address

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* 2. What is the training you're requesting? Please provide a short description. You can also paste a relevant URL (www)

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* 3. Who is providing/delivering the training? Please provide the name of the organisation.

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* 4. What is the cost of the training?

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* 5. Have you already paid for this training yourself?

Yes

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* 6. When is the training taking place?

Date - if the training is taking place across multiple days please only state when it starts

Date

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* 7. What competencies/skills will this training help you develop?

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* 8. How will this training improve your practice and benefit your patients?

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* 9. Practice manager's approval to attend

I confirm my practice manager has approved this request and agreed to release me from work to attend the training

Not applicable

Other (please specify)

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* 10. Your practice manager's email address

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* 11. Declaration

I confirm that, if this request is approved, I agree to complete an evaluation survey after attending the requested course/training (you will receive a link to the survey via email)