Voyager Medical half-day FACE-TO-FACE VaccinationTraining Enrolment Form                                    
PGD renew yearly; F2F/ Basic life support training every 3 years 


If you have any question or want to confirm your booking urgently, please  (You may contact our Training Coordinator Jenny on 07384968866 / 02079932544 if you required further support)
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Please fill-in your Order Confirmation reference number. * (Order  #XXXX) if you paid via   https://voyagermedical.com/shop/  Or put VMO-XXXX   if you paid via direct invoices with Voyager Medical  or  put "Paypal" if you paid via www.hubnet.io  Or put "Others" if paid by training partners  or your employer 
If you pay via alternative method or via training partners, please tell us how did you pay and the date of payment or name of training partners or your employer
(1) First Name *
(2) Surname / Family Name *
(3) UK Mobile No. *
(4) Email Address *
For your PGDs Online Training Platform Username registration
(5)  Professional Registration Body *
(6) Professional Registration Number (GMC / GPhC / GDC / NMC registration number) *
If you are not a Doctor / Pharmacist / Nurse / HCP / Pre-reg and Others please write 'N/A'
(7) Face-to-Face Training required? *
Required
(8) Please choose the Voyager Medical Training course which you are enrolled to:            *
you may choose more than one option(s)
Required
(9) FACE-to-FACE VACCINATION Training Date: (For Travel Clinic, Flu and COVID Vaccinator Training) *
Required
(10) Name of the Pharmacy / CQC Registered  Clinic *
(11) Post Code of the Pharmacy / CQC Registered Clinic *
Declaration
I certify that the above facts are true to the best of my knowledge and beliefand I understand that I subject myself to professional conduct breach in the event thatthe above facts are found to be falsified. *
Required
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