EOI form - Diabetes Care Education Scholarships | COORDINARE - South Eastern NSW PHN

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Diabetes Care Education Scholarships
EOI form - Diabetes Care Education Scholarships

Online expression of interest form

Diabetes Care Education Scholarships

Page 1 of 2

Section A1 - Eligibility criteria

I confirm I meet the following eligibility criteria:

Are you currently employed or have confirmed employment in primary care setting within South Eastern NSW? (required)

Do you hold current registration with relevant professional bodies such as AHPRA, ESSA, Dietitians Australia or the Australian Physiotherapy Association? (required)

What type of professional registration do you hold? (required)

If you chose other, please specify below:

Please provide the professional registration number below: (required)

Do you have an interest in expanding your knowledge and skills in diabetes management? (required)

Have you recently completed substantially equivalent diabetes training within the past 3 years, and do you have access to the selected course ? (required)

Are you available to commence the course in February 2027 and can commit to completing the course within six months? (required)

Can you attend a one-hour online interactive session following the course in late July? (required)

Do you have access to a computer and internet connection to complete the course? (required)

Unfortunately, you're not eligible for this scholarship

Thank you for your interest in COORDINARE's Diabetes Care Education Scholarship. Based on the information provided, you do not meet the eligibility criteria for this opportunity.

We appreciate your interest and encourage you to keep an eye on our funding opportunities webpage for future scholarships and funding opportunities.

Section A2 - Additional eligibility criteria

Which course are you applying for? (required)

Are you a student nurse or a Local Health District employee? (required)

You're eligible to apply for this scholarship

Thank you for confirming your eligibility. Please complete the additional information on page two to help us assess your application.

Unfortunately, you're not eligible for this scholarship

Thank you for your interest in COORDINARE's Diabetes Care Education Scholarship. Based on the information provided, you do not meet the eligibility criteria for this opportunity.

We appreciate your interest and encourage you to keep an eye on our funding opportunities webpage for future scholarships and funding opportunities.

Section B - Applicant details

Name (required)

Position / title (required)

Place of work

Contact phone number (required)

Contact email address (required)

Please select the LGAs you work in

Bega Valley

Eurobodalla

Goulburn Mulwaree

Kiama

Queanbeyan Palerang

Shellharbour

Shoalhaven

Snowy Monaro

Upper Lachlan Shire

Wollongong

Yass Valley

Jervis Bay Territory

How did you hear about this opportunity?

If you chose other, please specify below:

Section C - Declaration

This must be completed by the individual submitting the application:

I agree that I understand the course commitment and am able to participate in all scholarship activities (eLearning modules, post course evaluation, and one hour online workshop). (required)

I understand and accept that information provided in this application may be stored by COORDINARE – South Eastern NSW PHN in various hardcopy and/or electronic formats. (required)

I can confirm that the contents of this application are to the best of my knowledge accurate, complete and do not contain any false, misleading or deceptive misrepresentation, claims or statements. (required)

I understand that if the conditions of the funding are not complied with, COORDINARE – South Eastern NSW PHN may terminate the scholarship. (required)

Section D - Applicant signature

By entering your name and the date below, you acknowledge that this constitutes your electronic signature and confirms that the information provided in this application is true and correct to the best of your knowledge.

Applicant name (required)

Date (required)

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