SusQI Academy membership sign-up form

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The Sustainability in Quality Improvement (SusQI) Academy provides CPD training and support to SusQI Leads to help them embed sustainability into QI education and practice in their organisation. Organisations may choose to enrol a number of key staff in the Academy to access CSH expert support. Membership is available to those working within health professions education and/or in quality improvement, service transformation and health service delivery.

SusQI Academy Annual Membership provides CPD and support for key personnel including:

1. CSH Courses: Access to CSH technical workshops (SusQI*, Teaching SusQI, Carbon footprinting)

2. Quarterly Forums: Online forums led by CSH experts. Share current learning, challenges and network with peers.

3. Tailored mentoring hours: up to 12 hrs of flexible online mentoring across the year, e.g. to review current QI materials and provide support with embedding SusQI into current QI teaching/leadership. Where more than one Lead is signed up from an organisation mentoring time is shared between them.

4. SusQI Academy Network: An Academy members only online network space for resource and information sharing.

5. Exclusive resources: Access to members only area with exclusive SusQI resources.

6. Recognition as an Aspiring Beacon Site: Appear on the CSH Map, use the Beacon site logo for your material, receive a quarterly newsletter, share work at a national level inc. CSH's annual SusQI showcase

*individuals who have already done the SusQI course may choose another Centre for Sustainable Healthcare course to attend

Costs: Exclusive of VAT

Organisation Package One (Suitable for 1-2 leads): £3500 +VAT

Organisation Package Two (Suitable for 3 -5 leads): £5750 +VAT

Organisation Package Three (Suitable for 6-10 leads): £8950 +VAT

Mentoring time is shared between all the Leads.

Name of Organisation or Institution applying *

How many SusQI Leads does your organisation want to have enrolled in the Academy? *

Please note that mentoring time is shared amongst all Leads

Name of first SusQI Lead. (This will be your main contact point for the academy) *

Occupation and/or role *

Email address *

Additional individuals at your organisation/institution who are signing up as SusQI Leads

Please include name, email address and occupation/roles for all additional SusQI Leads

I understand the costs and agree to supply a PO number to CSH in order to generate an invoice for my organisation.

Please note these costs are exclusive of VAT.

Yes. I can raise a PO number and send to CSH

I need support in how to raise a PO order in my organisation

Membership years run in 4 enrolment cycles. Please indicate which cycle you wish to join in. PO number or full payment is needed prior to the start of your enrolment cycle

Please provide the name and contact details for the person responsible for the organisation of payment
*

Does your organisation require a Purchase Order (PO) to process payment? *

Are there any other invoicing requirements we should be aware of? Please provide details below.

Would you like to receive our monthly CSH newsletter to stay up to date on sustainable healthcare news, events and courses (Your lead contact can be added to the mailing list)? *

Yes

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