Expression of Interest: Paediatric Life Support - Kununurra - 12 November 2023

First name *

Surname *

Contact number *

Primary email address *

Please provide an email address you access most regularly, all course correspondence will be sent to this email address.

HE number *

Profession *

Current position title *

Practice/Hospital name *

Employer *

Clinical Department *

Work location *

Please list the location/s that you will be working at for the next 12 months.

Additional information to support application *

Were you a WACHS intern? *

Are you on the WACHS Rural Generalist Pathway? *

Cost

$300

*

Send me a copy of my responses

Powered by