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:

dd/mm/yyyy

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

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

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

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

please select all that apply

Send me a copy of my responses

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