*1.What is your full name?(Required.)

*2.What is your NHS email?(Required.)

*3.What is your contact number?(Required.)

*4.How many years have you been a General Practice Nurse? (Approx)(Required.)

*5.Which practice do you work at?(Required.)

*6.Which area do you work in?(Required.)

Bradford District and Craven

Calderdale

Kirklees

Leeds

Wakefield

*7.What is your practice manager's name?(Required.)

*8.What is your practice manager's email?(Required.)

*9.There is a requirement for participants to attend all four GPN Development Fellowship sessions. Please see locality dates below, can you commit to your locality sessions?

Bradford District and Craven sessions -
9am - 12:30pm at The Ridge Medical Practice, BD7 3JX:
Wednesday 23rd September 2026
Wednesday 27th January 2027
Wednesday 21st April 2027
9am - 4:30pm at Village Hotel Leeds South, LS27 0TS:
Wednesday 7th July 2027

Calderdale and Kirklees sessions -
9am - 12:30pm at Holiday Inn Brighouse, HD6 4HW:
Wednesday 30th September 2026
Wednesday 3rd February 2027
Wednesday 28th April 2027
9am - 4:30pm at Village Hotel Leeds South, LS27 0TS:
Wednesday 7th July 2027

Leeds and Wakefield sessions -
9am - 12:30pm at Village Hotel Leeds South, LS27 0TS:
Wednesday 7th October 2026
Wednesday 10th February 2027
Wednesday 5th May 2027
9am - 4:30pm at Village Hotel Leeds South, LS27 0TS:
Wednesday 7th July 2027(Required.)

Yes

No

Other (please specify)