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Trainee Application

Please complete the details below.

First Name*
Last Name*
Hospital Address Line 1*
Hospital Address Line 2
Town*
County*
Postcode*
Telephone* (inc area code)
Email*
Are you a consultant ?	Yes No
If no, please state grade*
Hospital/Address*
Trust*
Preferred Training Centre - 1st Choice
Preferred Training Centre - 2nd Choice
Preferred Training Centre - 3rd Choice
	* required fields

The National Training Programme Coordination Office will receive your completed registration form by way of an immediate automated notification.

Individual trainees will be contacted by email through the Coordination Office to formalise their registration with an application form, and request for a required accompanying letter of support from your Hospital Trust.

Upon completion of registration each trainee will be issued an individual login password to allow Global Assessment Forms (GAS) to be uploaded, which will also provide access to additional information which is available through the web site.

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