Applicant Details

Full Name *

Email Address *

Phone *

Organisation: *

Position/Title

Eligible Applicant Group *

Professional Accreditations or Industry Association Membership

Training Application

For more information on each of the approved training courses, visit: http://https://gcphn.org.au/practice-support/support-for-general-practice/disaster-response-and-mental-health-training-subsidy/#approved-training-opportunities

If 'Other', please provide course name & relevant website link.

Relevance of training opportunities to your current role/organisation *

I confirm that I have read the Disaster Response & Mental Health Training Subsidy Guidelines located on the GCPHN website prior to submitting this application. *