ࡱ> ad`} bjbjXX4L:f:fp;2 2 8|\~<&"!!!;;;;;;;$>ܴ#<^#<!!8<<<<F!!;<;<<668!P}Z6;N<0~<7AA888A8<#<#<~<A2 Y :  Additional Information Form for NHS Business Unit Thank you for applying for the short course/unit. NHS Business Unit requires you to provide evidence of meeting each criterion. Some sections are to be completed by you, and some by your employer/ manager. There may be some duplication in the information that you completed on the ý applications form, but you are requested to complete this form as comprehensively as possible, as omissions may delay the approval process of your application. There are 4 sections to be completed: Section 1About YouTo be Completed by YouSection 2Course OptionsTo be Completed by YouSection 3Invoice/ Funding SourceTobecompletedbyYou/ Employer/ Trust LeadSection 4ManagerscommitmenttosupportapplicantTo be signed by your Manager  Once the form is completed please send the form to NHS Business Unit Team, to email HYPERLINK "mailto:nhs-business-unit@beds.ac.uk" nhs-business-unit@beds.ac.uk (Admin team). Thank you in advance. NHS Business Administrator Section 1 About You YourFullName:. YourHomeAddress: YourDateofBirth: Your NMC PIN Number:  Please provide a copy of your NMC statement of entry with this completed form as evidence. Section 2 Course Options Course/ Programme you are applying for: Section 3 Funding Information Please mark one option from below:  3.1 Self-Funded If self-funded do not fill this section 3.2 Employer Funded If employer funded, please fill below: EmployerFullName:. EmployerAddress:.... ...... EmployersEmailAddress: EmployersContactnumber:... Purchase Order number: .... Date: ... Please provide sponsor letter on headed paper. This should contain: your name, employer, course you applied for, fee, name and signature of the person authorising funding. 3.3 Contract (HEE) Funded If contract funded, please fill below: TrustTrainingLeadauthorisation Pleaseprintname Trust Training Leads signature.... Date: . Please note: The ý will be unable to accept this application without correct authorisation. For all Contract funded applicants please ensure the Trust training lead has signed the above. For all Employer funded applicants please provide sponsor letter from the employer. Both Contract funded and Employer funded applicants need to bring proof of funding on registration day, otherwise they will be not able fully register. Section 4 Managers commitment to support applicant I hereby confirm my support for the above named applicant to undertake this course and will support assessment of the applicants practice in the clinical setting where relevant. Where a nominee is on a Tier 2 Visa, I confirm that they are being supported to undertake this training and are being funded and I confirm that they can study at the ý. Please note: Applicants on a Tier 2 Visa need to bring supporting letter from the employer on Registration day, otherwise International Office will be not able to register them. Pleaseprintname.. JobTitle Managers Signature..... Date..     PAGE   PAGE \* MERGEFORMAT 1 V2.0 56U\bc  K Z     ! " # & * - 7 N O Y Ϸ}}}}}vrvvvkv huhx}hx} huh* huh%_ huh) huh,qi huh ( huhJ9h3 huhRyhCfh ]5CJaJh}P6hRy5CJaJh}P6h15CJaJh}P6hd-5CJaJhuhd-5>*huhd-5 huh@Ajhuh}P6U'6 # - 7 N $dh$Ifa$gdx} $dha$gdx} $dha$gdB $dha$gdx} $dha$gdx} N O Y h  _PPP$dh$Ifa$gdx}kdJ $$IflFnU&b t0&    44 lapytx}Y g h ~    " # $ % * ? 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