Name* First Last Place of Work* Current Job / Role* Study Day or Course applied for including cost*Contact Details Email* If successful would you be willing to write a small summary on your experience and how this has helped in your role?* Yes No Have you applied for the bursary before?* No Yes If yes, were you successful and what was the name of the course?Sometimes part funding is offered, how will you pay the balance?It is helpful to Sylk if they know who has benefited from the bursary. may we pass on your email address?* Yes No Form will be submitted to Debra Holloway at Debra.Holloway@gstt.nhs.uk
