Improving outcomes through well-being; Mental health training for Cambridgeshire Children’s Workforce
CAMH Foundation Module course application form
Please complete all boxes as any incomplete forms will be returned and delay the processing of your application. Please ensure you enclose your payment/ invoice details
Name: (please PRINT)Job Title:
Employers full name:
Organisation – please select the most appropriate option
/ Cambridgeshire County Council
Voluntary Community Sector
Healthcare /
/ Education
Other
Service/Team
Full Address: / Telephone number:
Mobile number:
Email Address:(Confirmation will be sent by email to yourself and your line manager – therefore please ensure that you check your email regularly)
Managers Name: / Managers email:
CAMH Foundation Module
Start date: / Cohort
Are you able to commit to attend all aspects of the programme (see prospectus for details) Y / N
If not please outline details
Do you consider yourself to have a disability? Y / N / Please state any special requirements needed to enable you to attend and complete this training
How is this training relevant to your role?
Is this training identified in your PDP? YES / NO
How did you find out about this training?
Note: By submitting this application form you are agreeing to the terms of the training (see current prospectus for full details). We operate a cancellation policy and a fee will be charged to your organisation if you fail to attend confirmed training or cancel at late notice. Please ensure that you enclose your payment or invoice details as applications cannot be processed until these are received.
Invoice Address (for fee/ cancellation fee) / Budget code/ref:
FOR LEARNINGDEVELOPMENT TEAM USE ONLY
Date / Initial / Date / Initial
Application received / Course booked
Payment received / Place cancelled
Comments
Please note – confirmation will be sent by email unless otherwise requested
Please return to: CAMH Training Administrator, Block 14, Ida Darwin, Fulbourn, Cambridge, CB21 5EE.
Email: Tel: 01223 884040 Fax: 01223 884354