Application for funding to attend
Post Graduate Distance Learning Course in Gastroenterology, Queen Mary University of London 2016/2018
Registration Form
Name:…………………………………… IICMS Membership Number:…………..
Organisation: ………………………………………………………………………………
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Job Title:………………………………………………………..……..
Email Address:……………………………………….…………………
Contact Phone Number: ……………… (W) /…………………….…. (M)
Current Qualification: ………………………………………………………………
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Reason why you wish to undertake this course? …………………………………………………………………………………………………
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If you are successful in your application for funding and are accepted for a place on the above course,
You will have to agree to the following terms, as agreed with the HSE
(a) Sponsorship is reliant on successful completion by of the course
(b) If you do not complete the Course or absents from the Course (except in exceptional circumstances, i.e. sick leave), you will repay to the HSE such monies as is deemed appropriate.
(c) On successful completion of the Course you undertake and to remain in the employment of the HSE, based on the period of sponsorship, e.g. 2 year sponsorship will require you to remain in a further two year employment.
(d) Failure to adhere to condition (c) will result in you being liable to the HSE for repayment of the sponsorship paid during the course.
(e) The IICMS will not be held responsible for any monies owed to the HSE, and will not be liable for any other expenses incurred during your studies, eg travel expenses, books, attendance expenses at courses. This sponsorship is purely to cover the graduate fees associated with this course, specific to the amount €4,341 in ’16 and €4,251 in ’17. Any difference in exchange rates will at that the applicants expense.
I confirm that will I comply with these terms and conditions should I be successful
Signature:…………………………………….
Date: …………………………………………..
Places are limited; therefore please register your interest before 19th April 2016
The executive meeting is scheduled for 22 April, so applications will be processed then, in order for enough time to be given for application to QWUL
This is the link to the syllabus tot the course, it’s a distance learning post graduated course, with an option to upgrade to a MSc www.blizard.qmul.ac.uk
Return to:
Patricia Lawlor MSc
IICMS Chairperson
Faculty of GI Physiology
C/o GI Function Unit
GEMS OPD
St James Hospital, Dublin 8
Email:
Irish Institute of Clinical Measurement Science