RSPH Diploma Course

 in Anatomical Pathology Technology

Application Form

Please complete all sections 1 - 6 below - it is important that your take your time with this application.  It is recommended that you read the entire application in the first instance and then collect the necessary evidence and documentation required to complete it at a later stage. You will also need to complete your organisations financial details at the end of this from - for this you will need your finance departments contact and address details. 

 

 

Only one Microsoft Office document or PDF file can be uploaded via this page, ensure any pictures or scanned images (e.g. of ID badge, job descriptions, qualifications etc.) are pasted or scanned as one document before submission).

Important! Please ensure mentors read the Role of mentors page and declaration below.

Section 1:  Details of candidate:
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Gender:
Section 2: Work place mentor details:
Section 3: Candidates current employment details:
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Type of employment:
Upload employment evidence
PDF or word document only
Your employment supporting evidence:

To apply for this training you MUST be working in a mortuary as an APT in a substantive or trainee position. Please provide one piece of the following supporting evidence with  your  details on (you are required to upload a copy with this application form). Remember only PDF or Microsoft Office documents. 

Section 4: Candidate roles / duties and qualifications:

Evidence of qualifications:  to gain access to the level 4 Diploma (and top up course)  please see below for qualifications that must be uploaded with this application:

For level 3 Diploma applicants: Not required

For level 4 Diploma applicants: RSPH Level 3 Diploma APT certificate.

For level 3 Diploma top up applicants: Previous certificate & diploma.

Upload qualification evidence
PDF or word document only

You may be contacted prior to your attendance to discuss any additional  support required - documentary evidence may also be required for submission to RSPH when you attend the North Tees Centre.

NOTE: The Centre is not responsible for arranging / funding any further tests which may be required – please speak to your mentor if you require additional support with testing (dyslexia for example).

Section 5: Declarations:

The candidate:

I have read and fully understand the course requirements and eligibility criteria and commit to:

  • Completing the full course which will involve a time commitment of 10 days to be spread via modular learning as outlined in the timetable supplied

  • Completing all distance learning and assessment work, set within the timeframes as required

  • Completing a portfolio of competency of my skills and knowledge for final assessment by the RSPH

  • I have attached a copy of my employment evidence / work experience honorary contract (Applications will not be considered without this evidence)

The mentor:

The organisational mentor (at the organisation at which the applicant is currently employed / completing work experience) must read the following declaration.
I have read and fully understand the course requirements and eligibility criteria and commit to:

  • Providing work based mentor support to the candidate

  • Sharing my knowledge, skills and experience of all aspects of mortuary practice

  • Undertake regular assessment of the candidates practical skills

  • Provide the candidate with written evidence of skills demonstrated as part of the portfolio assessment

  • his/her release for the time required to participate fully in the training

The mentor is acting on behalf of your organisation to ensure full attendance and completion of this programme.

Section 6: Payment Options: Payment to be made no later than 4 weeks prior to commencement of the course. Payment must be provided to successfully register the candidate onto the course.

Cheque made payable to: North Tees and Hartlepool NHS Foundation Trust and post to:

Training lead,

Pathology department,

North Tees and Hartlepool NHS Foundation Trust

University Hospital of North Tees

Hardwick

Stockton on Tees

TS19 8PE

If you require any further information or guidance please use contact us link below.

Final checklist before submitting your application - have you:

 

Read the eligibility criteria for your course

 

Scanned and attached evidence of your employment (PDF or word documents only)

Scanned and attached previous qualifications (for level 4 and top up Diplomas only)  

An agreed work based mentor

Put in the PO number on your application (on contact of person who to send the invoice to) - this is essential for the application to proceed

Should you have problems submitting this application through your Trust account then please email us using this Microsoft Word version of the application form and 

email: Darren.Makin@nth.nhs.uk

North Tees Centre, Hardwick Rd, Hardwick, Stockton-on-Tees TS19 8PE