CPD Funding Application

By completing and signing this form, the learner is agreeing to the following: “I undertake to attend the full course of study, take any relevant exams at the end of the course and feedback to the Training Hub as requested on my learning outcomes and impact.” For more information on CPD Funding please see the CPD Funding Guidance Documentation found here. Please note funding for CPD applications for 2024/25 is still under review due to budget constraints. We will process your application and advise as soon as possible if we are either unable to fund or need to keep a decision on hold whilst we await confirmation of Training Hub finances. Our usual advice is perhaps just as important now as ever, please do not presume your application will be approved, if you have already paid for the course or it is starting soon, you will need to be prepared to possibly self-fund. We hope to be able to clarify our position by the end of April. Thank you.

1. Please tick here to confirm you have read the CPD guidance documentation accompanying this application form and that your line manager/employer is in support of this application. *

Yes

2. Date of application *

	DD/MM/YYYY

Applicant's contact details *

Name:	*
Email address:	*
Date of joining Primary Care:	*
Date of joining your current employer if different from above:	*
If previously applied for CPD under a different surname, please list that here	*

3. Applicant's Role/Profession *

4. Your employer: *

Employer (Practice/PCN):	*
Your Practice Manager's Name:	*
Your Practice Manager's Email Address:	*

CPD Funding Application

1. CPD Funding Application

1. Please tick here to confirm you have read the CPD guidance documentation accompanying this application form and that your line manager/employer is in support of this application. *

2. Date of application *

Applicant's contact details *

3. Applicant's Role/Profession *

4. Your employer: *