Instructions for completing application form

Please read the following instructions before completing the application form. If in any doubt please contact the General Manager for further help.

Applications should:

  1. Be from qualified radiographers, radiological technologists, radiological technicians or radiography lecturers/teachers.
  2. Be made or endorsed by the Head of the department or school of radiography/university (when application is from a school of radiography).
  3. Be used for the department as a whole.
  4. Show evidence of some active training/ information sharing within the department.
  5. Indicate training outcomes as a result of support being provided, and preparations that are already in place for that training.
  6. Provide information about the department to ensure the titles of books provided are relevant to the work being undertaken and the equipment being used.
  7. Give precise details of needs with regard to translations of technological information or preparation of papers for presentations.

Please note that the work address of the applicant should be the same as the address of the department or school of radiography requesting support.

Books and journals will not be posted to the applicant’s private address.

Books and journals are intended to benefit the whole department or school and are not for any individual’s sole personal use.

APPLICATION FORM

FOR SUPPORT

PERSONAL DETAILS OF THE APPLICANT:
Title (Mr/Mrs/Ms/Dr)etc:
Family name:
Given (first) name:
Home address with postal(zip) code:
Work address with postal (zip) code:
( this should be the same address as the department requesting support).
If it is not please state why you are applying for support.
Telephone number (home):
Telephone number (mobile):
Telephone number (work):
Email address
Professional educational qualification(s):
Current job title:
Full address of department or schoolof radiography requiring support.
Please include postal (zip) code.

DETAILS ABOUT THE APPLICATION YOU ARE MAKING:

On behalf of the department/school I wish to apply for:
(Please check only those boxes which are relevant to this application) / TEXTBOOKS – list subjects particularly required eg radiography, MRI, CT, ultrasound, anatomy
JOURNALS
OTHER EDUCATIONAL MATERIAL
(please indicate your specific needs)
GRANT FOR OTHER PURPOSES
(please indicate the purpose for which the grant would be used)
Separate form available for workshop application. / WORKSHOP
(please indicate what support is required. Please note the Trust does not provide monetary support for travel, or subsistence)
Describe the reason for your application and how the result will benefit you and/or your colleagues. Please be precise and show clearly what the benefits will be.
*Applications that do not give enough detail may not be considered for support and will be returned to you for additional information.

IMAGING DEPARTMENT DETAILS: (or school of radiography) applying for support

Number of radiographers in the department
Number of student radiographers if you are applying on behalf of a school of radiography
Other staff employed in the department / How many? / Job titles
Is your hospital a teaching hospital? / Yes / No
What types of radiological examinations are undertaken in your department?
*Please list as many as possible
(Continue on separate page if necessary)
Name of head of your department?
Does he/she support this application?
Name of the director / chief medical officer of your hospital?
What imaging and processing equipment does your department have?
*Please list all that apply, including processing equipment
(Continue on separate page if necessary)
List all of the textbooks you have already in your department / school of radiography
(Continue on separate page if necessary)
Signed:
Date:

Please let us know how you heard of WRETF ______

Completed application form to be returned by email to:

Miss S. Marchant

General Manager

WRETF

143, Corfield Street

Bethnal Green

London

E2 0DS

UNITED KINGDOM

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15.01. 2015