West Essex COMF
Please complete this form to register for your funded Dementia Interpreter E-Learning course. The information you provide here will be used to register an account on Pro Trainings in order for you to access the course. 

The course lasts around 2 hours in total but can be completed in bitesize chunks, meaning it does not all need to be completed in one go. This means you can work through the content at times that are convenient to you. 
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Please enter your first name *
Please enter your surname
Please provide a contact number *
What is your email address? *
Do you give permission for us to contact you? *
Do you give us permission to set up an account for you on Pro Trainings in order for you to access your Dementia Interpreter E-Learning? *
Do you live/work in West Essex? *
What is the postcode of your work/home address? *
Name of the company you work for (if applicable)?
Which area of Health & Social Care do you work in? *
Are you a family carer? *
You are applying to be given a funded credit for the Dementia Interpreter Course. Please confirm you will be able to complete this within 1 month. *
Please confirm that once completed you are willing to complete an evaluation of the course which may be published. *
Do you have a Smartphone? *
Please download the Dementia Dictionary App from either the App Store for iPhone or the Playstore for Android. All you need to do is search "Dementia Dictionary and keep an eye out for our logo. This is Free of Charge
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