GP Leaders Development (GPLD) Programme

GPLD Application Form

Name

First

Last

Job Title

Region

ICB Footprint

Organisation

Contact Tel. No.

Contact Email

Please share your leadership aspirations for the next 5 years

In no more than 100 words please tell us why you would like to participate in the CLN GPLD Programme

0 of 100 max words

How did you hear about the programme?

If social media or other, please specify:

Free for the first 20 applications, £1500 per delegate thereafter. If you apply after the first 20 applicants, do you still want to be considered:

Yes (If yes, we will be in touch for PO & additional Finance Information)

By selecting this box you are agreeing to attend the full programme and paying the cost of the programme in advance of day 1 (if required)

I agree

If you are human, leave this field blank.