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MND Connect Helpline: 0808 802 6262
Fundraising enquiries: 01604 611860
Shop with us
Search

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Education and Development
Enhancing MND Care Practice in Northern Ireland
Apply for Northern Ireland Education Award

Apply for Northern Ireland Education Award

Current Personal details
Employer contact details
Support in NI
Learning and development activity
Learning and development objectives
Evaluating the award
Complete

Personal details

Please ensure you have read and understood the full terms and conditions on our website before submitting an application.

Name

First name

Last name

Job title

Band/Grade

Phone

Mobile

Email

Membership of professional body

Please provide details of your professional registration or membership.

Membership/registration number

Expiry/Renewal date

Expiry/Renewal date: Day

Expiry/Renewal date: Month

Expiry/Renewal date: Year

Employer contact details

Organisation/Employer name

Address

Click here to enter your address manually.

Address

Address Line 1

Address Line 2

ZIP/Postal Code

City/Town

State/Province

Country

Support in NI

Supporting people affected by motor neurone disease (MND) in Northern Ireland

What percentage of your role is spent working with people affected by MND?

Less than 10%

10-25%

25-50%

50% or more

100%

How often do you provide care or support to people affected by MND?

Annually

Monthly

Once a week

2 to 3 times a week

More than 3 times a week

Daily

Please explain your ongoing professional commitment to improving care for people with and affected by MND in Northern Ireland.

Maximum 400 words.

Learning and development activity

Please give full details of proposed activity

Maximum 400 words.

Organisation or institute hosting proposed activity

Start date of proposed activity

Start date of proposed activity: Day

Start date of proposed activity: Month

Start date of proposed activity: Year

End date of proposed activity (if applicable)

End date of proposed activity (if applicable): Day

End date of proposed activity (if applicable): Month

End date of proposed activity (if applicable): Year

Cost

Do you require financial assistance with travel and/or accommodation?

Yes

No

If yes, please give full details of what is required and costs

Learning and development objectives

Please clearly list all your learning objectives for your proposed activity

Maximum 400 words.

Please explain how this activity will improve your practice and care/support for people affected by MND in Northern Ireland

Maximum 400 words.

Evaluating the award

Please tick all of the following boxes

I agree to submit a certificate of attendance or similar if an award is made

I agree to complete a questionnaire and/or participate in a telephone interview conducted by the Association or partner thereof if required

I agree to present a summary paper at the Northern Ireland branch committee and/or to write a summary article for publication in local newsletter if requested?

I agree to the Association publicising my receipt of the bursary

I understand the MND Association reserves the right to recover the cost of the education activity if the terms and conditions are not adhered to

Would you like to receive regular updates on the work we are doing and ways in which you can be involved, these could include educational newsletter, or invites to educational or special events?

Yes

No

Communication preferences

Email

Post

Phone

Text message

Who would you like to share this with?

We will share resources to the email address you provide. The email will include your name in the subject line and the following message: 'I have found these information resources that you may find helpful too.'

Enter your name

Enter recipient's email address

Email sent successfully

We have shared these resources with the email address you entered.

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