Apply for Continuing Professional Development Fund

The information we collect through this application form will be used to process your application to the MND Association CPD Fund. We may also used anonymised data to report on the use of the CPD Fund and its impact. This document will be stored in our client relationship management system and handled in accordance with our Privacy Policy.
Personal details
First name
Surname
Job Title*
Band/Grade:*
Employer contact details:*
Employers' Address*
Street Address Address Line 2 Town/City County Postcode
Telephone*
Mobile:*
Email*
Membership of professional body
Please provide details of your professional registration or membership:
Expiry/Renewal date

Support for people affected by motor neurone disease (MND)
What involvement do you have with people living with MND?*
Activity applied for
Education course
Formal education/courses including a contribution towards post graduate modules where appropriate. Maximum award £250 (and up to £250 in any one rolling year)
Title of education activity/course:*
Organisation or institute hosting education activity:*
Address*
Street Address Address Line 2 Town/City County Postcode
Phone*
Mobile:
Email Address*
Start date of education activity:*
End date of education activity (if applicable):*
Cost:
Learning objectives
Please list your learning objectives for this education activity:
Please explain how this activity will improve your practice and care/support for people affected by MND?

Support for conference presentation
Travel (mileage, public transport, parking) and/or poster printing costs required to give an MND related presentation at a conference (with priority for the APF and CoP face to face networking events). Maximum award £150. The Association will not meet associated costs such as books, accommodation or other expenses
Title of conference
Conference organiser
Title of presentation
Audience and anticipated number
Amount applied for
Learning objectives
Please list your learning objectives for this activity:
Please explain how this activity will improve your practice and care/support for people affected by MND.

Personal details