Programme Application Form Please complete the form below and select the module(s) that you wish to apply for. We will be in touch with you as soon as possible.Please enable JavaScript in your browser to complete this form.Name *FirstLastDate of Birth *DD/MM/YYYYPhone No. *Email Address *EmailConfirm EmailHome address for correspondence *Select Module(s) you wish to apply for: *Care Support 5N0758Communications 5N0690Safety & Health at Work 5N1794Infection Prevention and Control 5N3734Work Experience 5N1356Care of the Older Person 5N2706Palliative Care Support 5N3769Person Centred Focus to Disability 5N1728Care Skills 5N2770Intellectual Disability Studies 5N1652Manual Handling and Safe Patient MovementEntry Criteria: No formal qualifications required but competent in spoken and written English. Have reached the standards of knowledge, skill and competence associated with Level 4 of the National Framework of Qualifications. This may have been achieved through a formal qualification or through relevant life and work experience *I confirm I meet this criteriaAre you currently employed in healthcare? *YesNoIf so, what is your job title?How long have you been employed in this role?Do you hold a Junior Certificate or equivalent (Level 3 on the Irish NFQ)? *YesNoDo you hold a Leaving Certificate or equivalent (Level 4 on the Irish NFQ)? *YesNoPlease list your educational qualifications *(E.g. Level 5 award, Junior Certificate, Leaving Cert, etc.)What do you hope to learn from this programme?If you think you may need additional assistance to successfully complete this programme please tick “Need Assistance” and the Quality & Training Officer will discuss this with you on a confidential one-to-one basis *Need AssistanceDo Not Need AssistanceAre you a medical card holder? *YesNoIf yes, you are exempt from certification fees. Please furnish copy of medical card as proof of exemption. Are you in receipt of social welfare? *YesNoIf yes, you are exempt from certification fees. Please furnish copy of social welfare receipt as proof of exemption. I consent to having my contact information be shared with the RSG recruitment team so that I may be contacted about future work opportunities. (Opt out at any time by contacting RSG) *I consentI do not consentData Protection: Under the Data Protection Act 1998 and the Data (Amendment) Act 2003 and GDPR May 2018, personal information and assessment material recorded manually and electronically will be stored safely and treated as confidential by RSG Flexible Learning College. Such data will be processed fairly for specified purposes and on the basis of the consent of the person concerned or some other legitimate basis laid down by law. All learner information given on this form will be kept confidential and will only be shared for the purposes of authentication, certification and monitoring. For more information visit our privacy page: www.rsgcollege.ie/privacy *I have read, understand and consentCommentSubmit After clicking “Submit”, you will be given the option to make a payment for the course online. FacebookTwitterLinkedinPinterestemailPrint