NURSING EDUCATION APPLICATION 2016
The Foundation of Paediatrics
All queries and applications can be submitted to the Administrator, Nursing
Education via email nursing.education@rch.org.au or to extension 56716.
The Foundation of Paediatrics is a comprehensive program that explores the essential principles of paediatric
nursing. All sessions are presented by nursing and allied health professionals with a commitment to
providing current, evidence based information. Suitable for registered and enrolled nurses new to the field
of paediatric nursing or those wishing to revise their general paediatric nursing knowledge.
Due to limited the places available and high popularity of this program, all staff require signed approval
from
their
Nurse
Unit
Manager.
Any
cancellations
must
be
made
in
writing
to
nursing.education@rch.org.au as soon as practicable so that places can be made available to those on
waiting lists. Places are not transferrable between staff, and any changes must be requested to Nursing
Education directly.
Please note that all requested information is mandatory and must be provided. Incomplete forms
will not be processed.
PERSONAL DETAILS
NAME:
MAILING ADDRESS:
EMAIL (RCH):
MOBILE NUMBER:
UNIT/DEPARTMENT:
QUALIFICATION LEVEL
(registered or enrolled):
PROGRAM ATTENANCE
[Select only 1 option]

PROGRAM 1
Monday 22nd and Tuesday 23rd February

PROGRAM 2
Monday 29th & Tuesday 30th August

PROGRAM 3
Monday 21th & Tuesday 22th November
Places are limited, and your attendance is not finalised until you receive a confirmation email.
MANAGER APPROVAL
I acknowledge that I am aware of and support the above-named applicant’s attendance
at The Foundation of Paediatrics program over the selected dates.
[Please clearly print name, sign and date below]
NURSE UNIT MANAGER NAME
Nursing Education 2016 | Royal Children’s Hospital Melbourne
SIGNATURE
DATE