Expression of Interest

Please complete this form if you are interested in completing the course Immunisation Training for Aboriginal Health Workers and Aboriginal Health Practitioners at the Aboriginal Health Council of Western Australia. We cannot guarantee training in any location, but by registering your interest you are making us aware of areas where larger numbers of people are interested

Name*

Date:*

Best contact number:

Email:*

Have you completed the Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health Care practice or the Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health Care*

this is a mandatory pre-requisite for this course

Yes

Which of these units did you complete in your Cert IV*

Select

Do you hold a current CPR certificate*

This is a pre-requisite of this course

Yes

Where would you prefer to complete this training*

please select all that apply

Select or enter value

If you answered other please state where you would prefer to complete this training

please note we cannot guarantee training at any location, but if there is significant interest in a location we would endeavour to provide immunisation training there

Are you currently employed by an Aboriginal Controlled Community Health Service*

Yes

Are you currently employed by the Department of Health*

if so please select the location from the drop down list

Select or enter value

Which month(s) would you be able to attend immunisation training*

please select all that apply

Select or enter value

Send me a copy of my responses

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