Application for Genomic Medicine Master’s Funding Thank you for your interest in applying for funding. Please fill the form below carefully, ensuring that you check the information for accuracy before submitting your application for funding. 1. Applicant detailsTitle*MrMrsMissMsDrFirst name*Last name*Email* 2. Current employment detailsDo you hold a contract of employment with the NHS in England?*YesNoAre you a healthcare professional currently employed in England?*YesNoIn which ‘section’ of the healthcare workforce do you work?*Please specifyAllied Health ProfessionalsDentistryHealthcare scienceHealthcare managementMedicalMental healthNursing and midwiferyPharmacyPublic healthOtherJob title*Please provide details of your current role:*Are you registered with a professional body?*Please selectGMCNMCHCPCGPCOtherNoIf other: "please specify"*Please provide your registration/membership no*Employer’s full address* Address line 1 Address line 2 City County Postcode Is your Trust part of a designated Genomic Medicine Centre (GMC)? If so, which one?*Please specifyEast of England NHS GMCSouth London NHS GMCNorth West Coast NHS GMCGreater Manchester NHS GMCNorth Thames NHS GMCNorth East and North Cumbria NHS GMCOxford NHS GMCSouth West Peninsula NHS GMCWessex NHS GMCImperial College Health Partners NHS GMCWest Midlands NHS GMCYorkshire and the Humber NHS GMCWest of England NHS GMCI'm not working in a GMCDon't knowName of senior line manager*Senior manager is defined as someone in a position of responsibility who can make decisions on absence from work and the appropriateness of undertaking the selected training programme.Contact telephone number:*Email address of your senior line manager* Please provide the email of your Senior Line Manager who has the authority to approve your application and authorise any agreed study leave. Once you have submitted this form, they will receive an email containing details of your application and will be required to approve it by following the instructions provided in the email. If they do not receive an email regarding your application please ask them to search their junk email folder.3. Programme of study detailsWhat is your preferred mode of study?*Full TimePart Time (50% Funded)We only have fully funded full time MSc or 50% funded part time MSc at limited universities available.Has your university application been successful?*YesIt is in progressI have not started my applicationFull Time StudyWhich university are you applying to?*We only allow funding applications to a single university. If your university application is unsuccessful, you will need to reapply for funding by contacting firstname.lastname@example.orgUniversity of BirminghamNewcastle UniversityUniversity of ManchesterUniversity of SheffieldUniversity of SouthamptonUniversity of ExeterYour start date is*Part Time StudyWhich university are you applying to?*We only allow funding applications to a single university. If your university application is unsuccessful, you will need to reapply for funding by contacting email@example.comUniversity of BirminghamNewcastle UniversityUniversity of ManchesterUniversity of SheffieldUniversity of SouthamptonUniversity of ExeterYour start date is*4. Additional informationPlease provide any other relevant information that may assist in making a decision about this application for funding:Have you previously applied for Genomics Education Programme funding?*YesNo If you DO NOT want your application shared with your selected course provider and GMC please UNCHECK this box. If you DO NOT want to receive information regarding futher oportunities from the Genomics Education Programme please UNCHECK this box. CaptchaTermsBy clicking 'submit' you agree that your application is accurate and complete to the best of your knowledge and also that you consent to the details of your application being shared with your line manager, the University you are applying to and any other professional organisation needed to assess and verify your application.CommentsThis field is for validation purposes and should be left unchanged.