2024 Subsidy Application for Palliative Care Postgraduate Study -
Hume Region

Contact Sarah Finlayson with any queries 0417 780 684.

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1. Name (Required.)

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2. Telephone number (Required.)

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3. Email (Required.)

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4. Address (Required.)

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5. Professional Position (Required.)

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6. Name of organisation where you are currently employed (Required.)

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7. Have you completed an application for the Transition to Specialty Palliative Care Practice course? (Required.)

Yes

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8. Name of the Post Graduate course you are enrolled in (if not the Transition to Specialty Practice Course)

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9. Name of Academic Institution (if not the Transition to Specialty Practice Course)

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10. Has the course/unit/subject been paid for in full? (Required.)

Yes

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11. Please describe your role in relation to provision of palliative care? (Required.)

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12. What are the expected outcomes of this professional development and how will it impact on your role, clients, carers and families and other professional stakeholders you work with? (Required.)

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13. Declaration of course fee funding/subsidy received from another source. Please tick the correct response. (Required.)

In relation to this course I have not received funding from another source

In relation to this course I have received funding from another source.

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14. Please provide the name and e-mail of your Manager if you are applying to undertake the course during work hours and/or if your organisation is funding all or part of the course. (Required.)

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15. Declaration

I declare that all information provided in this application is true and correct at the time of submission.

2024 Subsidy Application for Palliative Care Postgraduate Study -Hume Region

Question Title

* 1. Name (Required.)

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* 2. Telephone number (Required.)

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* 3. Email (Required.)

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* 4. Address (Required.)

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* 5. Professional Position (Required.)

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* 6. Name of organisation where you are currently employed (Required.)

Question Title

* 7. Have you completed an application for the Transition to Specialty Palliative Care Practice course? (Required.)

Question Title

* 8. Name of the Post Graduate course you are enrolled in (if not the Transition to Specialty Practice Course)

Question Title

* 9. Name of Academic Institution (if not the Transition to Specialty Practice Course)

Question Title

* 10. Has the course/unit/subject been paid for in full? (Required.)

Question Title

* 11. Please describe your role in relation to provision of palliative care? (Required.)

Question Title

* 12. What are the expected outcomes of this professional development and how will it impact on your role, clients, carers and families and other professional stakeholders you work with? (Required.)

Question Title

* 13. Declaration of course fee funding/subsidy received from another source. Please tick the correct response. (Required.)

Question Title

* 14. Please provide the name and e-mail of your Manager if you are applying to undertake the course during work hours and/or if your organisation is funding all or part of the course. (Required.)

Question Title

* 15. Declaration

2024 Subsidy Application for Palliative Care Postgraduate Study -
Hume Region

1. Name (Required.)

2. Telephone number (Required.)

3. Email (Required.)

4. Address (Required.)

5. Professional Position (Required.)

6. Name of organisation where you are currently employed (Required.)

7. Have you completed an application for the Transition to Specialty Palliative Care Practice course? (Required.)

8. Name of the Post Graduate course you are enrolled in (if not the Transition to Specialty Practice Course)

9. Name of Academic Institution (if not the Transition to Specialty Practice Course)

10. Has the course/unit/subject been paid for in full? (Required.)

11. Please describe your role in relation to provision of palliative care? (Required.)

12. What are the expected outcomes of this professional development and how will it impact on your role, clients, carers and families and other professional stakeholders you work with? (Required.)

13. Declaration of course fee funding/subsidy received from another source. Please tick the correct response. (Required.)

14. Please provide the name and e-mail of your Manager if you are applying to undertake the course during work hours and/or if your organisation is funding all or part of the course. (Required.)

15. Declaration