Funding Application Form

Application for AI Rx – Essential AI for Clinicians

Delivered by: DREEAM (NUH)
Delivery type: Face to Face
Start Date: 15/01/2026

Please complete the details below for each attendee you wish to apply for funding for this course. (Fields marked are mandatory.)

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AI Rx – Essential AI for Clinicians 15/01/2026
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Attendee Information

Title (Mr/Mrs/Miss/Ms/Mx/Dr etc)

First name

Last name

Employee Number (Found on your payslip)

Job Title

Department

GMC/NMC number

Care Group

Staff Group

Staff Group: Other - please state

For the monitoring of Quality and Diversity purposes Health Education England / NHS England would value this information to be collated by all organisations who are awarded CPD funding. This information is sent confidentially and anonymously to HEE/NHSE to ensure that we offer equal access to training and learning at NUH. Our aim at NUH is to ensure equal access to education and training for Nurses, Midwives and AHP's and this data will support this to be achieved.

Are you happy to complete the Equality Monitoring Form?

Yes

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Attendee Contact Details

Attendee's Email Address Please check carefully that the email address you have entered is correct, as it is used for important communications regarding your course, including booking confirmation and, where applicable, payment and access to our e-learning resources.

Telephone