Practice ManagerBursary application form for attendance at QI Skills Day 2017

A Practice Manager Bursary will be provided with a ticket toQI Skills Day 2017plus up to £100 towards travel to and from the event. Successful applicants will be expected tocreate a series of related itemsafter attending the event as part of their acceptance of the bursary.
Please read the Terms and Conditionsbefore completing this form.
Section 1: Personal Details
Title / Surname
First/middle names
Address
Postcode / Email
Country / Mobile
Direct tel. / Dept/work tel.
Registration number:
Section 2: Eligibility
These bursaries are available to any Veterinarian currently employed as a practice manager at the time of QI Skills Day 2017 (15th November 2017). Please provide a brief resume of your careeras a practice manager to date.
Max 250 words.

Section 3: What does Quality Improvement mean to you?

Please give a brief explanation of your Knowledge of QI, and how you would like to start/have started implementing QI strategies in practice.

Max 350 words.
Section 4: Delivery schedule
The bursary-holder will be required to produce various outputs in acceptance of the bursary; these are included in the table below. Further details of the outputs are included in the terms and conditions for the bursary.Any major change in the completion date of these milestones will have to be submitted for approval in writing to RCVS Knowledge at .
Deliverables / Completion date / Please tick to accept
News item/opinion piece for the RCVS Knowledge website / by July 2018 /
QI case study / by August 2018 /
Speak at an approved event or participate in an interview with RCVS Knowledge / by January 2019 /
Section 5: Terms and conditions

I have read theTerms and Conditions relating to this grant and in the event of a successful application; I agree to abide by them

What happens next?

Please send your completed application form to efore 18th September. We will email you to let you know that we have received your application. We will then email you again to let you know if your application has been successful. If successful, attached to the email will be a Confirmation Form, which you will need to complete by the 30th September. Once we receive your returned Confirmation Form, we will book you in to attend QI Skills Day 2017 and we will send you an Expense Claim Form. You should send your Expense Claim Form with your receipts to us so that we can reimburse you for up to £100 towards your travel costs to attend the event. If you require any assistance or further clarification relating to the bursary scheme, please contact Kate Jefferies at .

Data Protection

RCVS Knowledge does not share personal information with third parties. By submitting this application, you are agreeing to the reasonable publication of your name and award.

Practice Manager Bursary application form / August 2017 / Page 1 of 2