SalfordDiscoveringGPN.com

Apply for a place on the module

First Name *

Surname *

University/NHS/Work Email Address *

Personal Email Address * (We are very interested in understanding if completing this module helps students pursue a career in general practice and therefore ask you provide a second email address to ensure we can contact you if there are changes to your primary email)

I am a ... *

Your Gender

Your University or Organisation (Free Text)

Which Region Are You Based In?

Your Ethnicity

Do You Have A Disability?

Registered Nurse/Nursing Associate PIN number (if applicable)

Please write a few sentences explaining why you want to take this programme (max 150 words)

Terms and Conditions

Terms and conditions - salforddiscoveringgpn.com

I understand that my place on this module is funded by NHS England and I confirm that I am making a commitment to undertake the full 12 weeks of study.

I agree to activate my account and start the module within 4 weeks of receiving the module activation email and understand if I do not then my place may be offered to someone else.

I have read and agree to the terms and conditions

University of Salford - Discovering GPN

Apply for a place on the module

Terms and conditions - salforddiscoveringgpn.com