ApplicationTest

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PROGRAMME STUDENTS:

If you want to make a programme selection you do not need to complete this form. Please contact your course office directly at pghealth@city.ac.uk for further details.

The application cannot be used to apply for Independent/Supplementary Non-Medical Prescribing modules (e.g NMM110). It can be used for the optometry prescribing modules.

In order for us to ensure your application is processed in due time, please ensure we receive your application at least 6 weeks before the module start date.

If you do not receive an automated response within 1 hour after submitting this form, please contact healthcppd@city.ac.uk 

Course Details
Course Information








Personal details

Please fill in your contact details to apply







Please enter in the format: DD/MM/YYYY



Correspondence






Permanent

Please input your permanent residence address










If you have previously studied at City please provide your student number. Failure to do this could result in your application being delayed.


Employment

No, I am not currently employed

Please continue to the education section

Yes, I am currently employed


Where you are based mostly.

Name of ward or department you report to most.



Education
Qualification

Please enter your highest academic qualification.






Please enter date in the format MM/DD/YYYY


English Requirements


Majority English Speaking Countries
  • Antigua and Barbuda
  • Australia
  • The Bahamas
  • Barbados
  • Belize
  • Dominica
  • Grenada
  • Guyana
  • Ireland
  • Jamaica
  • New Zealand
  • St Kitts and Nevis
  • St Lucia
  • St Vincent and the Grenadines
  • Trinidad and Tobago
  • United Kingdom
  • United States of America
No, English is not my first language

If English is not your first language, you must show evidence that your command of the English language is suitable for entry to degree-level studies.

A pass in the following qualification is the minimum expectation of City University London:

  • IELTS Test of the British Council at 7.0

Please enter dates in the format DD/MM/YYYY


Criminal Records Check

Payment


Self Funded
Returning Student

As a returning student to City, you will be sent a link to Epay with your confirmation email. Please use this to make payment, you will need your Student Number.

New Student

As you are a new student to City, we will contact you soon with regards to making payment.

NHS Trust




Disclaimer -  If the chosen trust does not agree to fund you then you will receive an invoice and be liable for the fee

Sponsor

If your employer does not have a funding agreement with City, or does not wish to use the allocated funds in the agreed contract, a sponsor form must be completed. This will be sent to you once your have submitted this form.



Click the add more address details link to provide a more detailed address
Add more address details

Please continue onto the next section

Reciprocal

Disclaimer - If your employer does not have an agreement in place with City then you will be liable for any fee





Equal Opportunities

In order for us to assist in our Equal Opportunities monitoring please tick one of the following boxes, which best describes your Ethnic Origin


Additional Requirements

Please complete the following section if you are applying for CH3020, NM3272, NM3287 or CHM002:


OVM053

NM3272

CH3040

NM3287
CHM002

RDM030

RDM032

NM3320

NMM320





Yes - I am applying for NM3287



Final Submission

We reserve the right to close or cancel a module at any point. You must provide 7 calendar days' notice if you wish to cancel a module. 


I agree that the information given on this form may be processed by City, University of London in accordance with the Data Protection Act, in particular, for the purposes of the equal opportunities monitoring. Where I am funded by my employer, I understand that my results, attendance and information about serious academic or other dishonesty will be shared with them by City.

http://www.city.ac.uk/dataprotection



Click here to enter text

Please complete this form and send it on to HealthCPPD@city.ac.uk

Independent Prescribing – Additional Information Form

Click here to name this section
Optometrists wishing to gain entry onto the Independent Prescribing module at City University.

NB Applicants may be called to interview to discuss evidence of up-to-date knowledge and experience prior to entry on the Independent Prescribing module.  Please note that you must have completed (or be familiar with) OVM050 – Principles of Therapeutics prior to completing this module.  You are required to complete the following modules as part of the prescribing programme – OVM050 Principles of Therapeutics/OVM051 Principles of Prescribing/OVM053 Independent Prescribing prior to completing the clinical placement.








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