Incomplete applications will not be considered.
Questions? Email email@example.com
To complete this application, you will need:
1) General Contact Information for each team member (2 members required)
2) A 400 word statement of interest
3) Three institutional goals (write three goals that you will accomplish after completing the course)
4) Obtain a letter of support from an institutional administrator and have them initial the support form. You can access the support form here: https://drive.google.com/file/d/0BybNs0gR7BJ4NXJOY0JfbkxfZ3c/view?usp=sharing
The letter of support and administrator support form need to be emailed to: firstname.lastname@example.org
As part of the application, we ask that you submit, as a team, three realistic and practical goals that you will achieve to improve communication support in your institution after attending the course. Goals are highly encouraged to include a measurable component, so that you can determine their impact within your institution. During the course you will have time to discuss and refine your goals but we want your ideas to begin germinating here.
Please limit response to box provided. Each box limited to 400 characters & spaces.
Sample Goal: To establish a monthly educational session on communication for oncology nurses and to measure satisfaction of the educational session.
Please access and print this form. The successful implementation of the curriculum will depend on support and commitment from your institution. An administrator from your institution is asked to provide one letter indicating the support of and commitment to your team’s effort to advocate for improved communication. Qualified institution administrators to supply these letters include the following: Director of Nursing/Patient Care Services, Chief of Staff/Medical Director, or Institution Administrative Official. Please give the form to your chosen institutional administrator. The form explains the purpose of this letter of support. Please ask your institutional administrator to read and initial the form.
After receiving the form and letter of support from your admin, and after you have completed this online application, please email the initialed form and letter of support to email@example.com