Statement of Commitment I agree to be bound by the Booking Conditions as outlined in the Course Information above and understand that cancellation penalties will apply should I not complete the course. I confirm that, to the best of my knowledge, the information given in the form is correct and complete. I acknowledge that if this application is approved I am committed to participation. Please sign here to acknowledge your acceptance of the Booking Conditions above: (scanned signatures accepted) Executive/Organisational Authorisation First name Surname Role Chair Chief Executive Other (please specify): Address Direct Dial Mobile Number Chief Executive/Chair Authorisation I to be bound by the Booking Conditions as outlined in the Course Information above and understand that cancellation penalties will apply should the delegate not complete the course. I acknowledge that the NHS South West Leadership Academy is not responsible for payment of backfill, accommodation, travel or subsistence. I to provide the conditions, resources and study leave to ensure successful attendance and completion of the entire programme. Where appropriate I will ensure the release of the applicant as appropriate. I agree to provide ongoing personal support for the applicant’s development. Please sign here to confirm your authorisation for this individual to undertake the course as per the above authorisation statements: (scanned signatures accepted)
Statement of Commitment I agree to be bound by the Booking Conditions as outlined in the Course Information above and understand that cancellation penalties will apply should I not complete the course. I confirm that, to the best of my knowledge, the information given in the form is correct and complete. I acknowledge that if this application is approved I am committed to participation. Please sign here to acknowledge your acceptance of the Booking Conditions above: (scanned signatures accepted) Executive/Organisational Authorisation First name Surname Role Chair Chief Executive Other (please specify): Address Direct Dial Mobile Number Chief Executive/Chair Authorisation I to be bound by the Booking Conditions as outlined in the Course Information above and understand that cancellation penalties will apply should the delegate not complete the course. I acknowledge that the NHS South West Leadership Academy is not responsible for payment of backfill, accommodation, travel or subsistence. I to provide the conditions, resources and study leave to ensure successful attendance and completion of the entire programme. Where appropriate I will ensure the release of the applicant as appropriate. I agree to provide ongoing personal support for the applicant’s development. Please sign here to confirm your authorisation for this individual to undertake the course as per the above authorisation statements: (scanned signatures accepted)
Improving-care-Application-form-w-equal-opps.docx