Course application - Great North Air Ambulance Service

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I am applying for*

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What date are you applying for?*

Name*

Title First Last

Date of Birth*

Email*

Main Contact Tel No.*

Please enter any other contact numbers in the personal statement field below.

Residential postcode*

Postcode

Address*

Street Address Address Line 2 City Country

Place of work*

Current position held (including grade)*

Designation*

Grade*

Years post registration*

Registration No.

(GMC/NMC/HCPC)

Please describe your experience in anaesthesia and critical care in your career so far.*

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Please describe your experience of delivering care within a pre-hospital environment.*

Professional experience and personal statement*

This includes hopes and expectations upon completion of the course.

Any disabilities that may restrict you from carrying out any elements of the course?

Do you have any dietary requirements?*

Yes
No

Please let us know your dietary requirements*

Clothing size*

UK Shoe size*

Upload photograph

Not required but will help the faculty deliver feedback on the course

Max. file size: 2 MB.

Would you like us to keep in touch about future training courses?*

Yes
No

These preferences are separate to the fundraising preferences below. All communications regarding future training courses will be via email.

How would you like to hear from us?

We'd love to keep you up-to-date with our lifesaving missions and how you can help us rescue more people through fundraising, events and volunteering. Please let us know how you'd like to hear from us.

Email
SMS

We may also communicate with you by post or telephone to tell you more about our upcoming training opportunities. You can read more about this in our Privacy Policy or you can click here to not receive communications this way.

How would you like to hear from us?

We'd love to keep you up-to-date with our lifesaving missions and how you can help us rescue more people through fundraising, events and volunteering. Please let us know how you'd like to hear from us.

Post
Telephone

Please note
If your application is unsuccessful for this year, you will need to reapply next year.
If you have opted to hear from us in the future, we will only keep your personal contact information and delete your application form data.
The GNAAS privacy policy can be found here.

I have read and agree with the terms and conditions*

Click here to view the terms and conditions.

I agree

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GNAAS course application