Tele-education Application Form

Please complete the application form below if you would like to participate in the Paediatric Tele-education course starting April 7th 2020. Once you have completed and submitted the form you will be redirected to the online shop where you can make payment for the course.

Alternatively if you would like to pay by cheque, you can print out and fill in an application form provided below and send it to us. Mailing details are provided on the application form.

Click here to download an application form to print. →

As soon as we approve your application and payment we will send you a confirmation email and further details for accessing the E-learning site.

Personal Details

First name *
Last name *
Job role *
Professional registration no. *
Place of work *
Health board
Home address 1 *
Home address 2
City *
Postcode *
Phone
Mobile
Email *

Course Details

Please select your payment option *
If you are opting for the discounted price, please provide your membership no.
Additional comments

Code of Conduct

To participate in Tele-education we require you to agree to the following code of conduct:
• Application to Tele-Education is only available to registered health professionals.
• As part of a group learning experience, candidates are reminded that the needs of each course candidate will be different.
• Live sessions will be recorded and the recordings will be available for registered participants to access through the BASICS E-learning website.
• Access to live sessions and to the video recordings is only granted to the registered candidates. It is not acceptable to offer access to these to anyone else unless permission has been granted in writing by BASICS Scotland.
• You may access content solely for your information and personal use. BASICS Scotland Tele-education learning materials, including recordings of education sessions, may not be downloaded, copied, reproduced, distributed, transmitted, broadcast, displayed, sold, licensed, or otherwise exploited for any other purpose whatsoever. Accessing the content for any other purpose or in any manner is expressly prohibited.
• You agree to not use or exploit the BASICS Scotland content in any manner inconsistent with any of the rights granted or restrictions set forth herein, including, without limitation, prohibitions on downloading, redistribution, alteration, deletion and deactivation of any content protection mechanisms. You are not allowed to modify, enhance, edit, translate, adapt, reverse engineer, decompile, disassemble, or create derivative works based upon or otherwise alter in part or in full any BASICS Scotland material.
• All material available to candidates is monitored and anyone who is found to be in breach of this code of conduct will be removed from the course.
Please state that you have read and agreed to the Code of Conduct before you continue. * I have read and agree to the Code of Conduct.

We want you to know exactly how our service works and why we need your contact details. Please state that you have read and agreed to our Privacy Policy and Terms & Conditions before you continue. * I have read and agree to the Privacy Policy and Terms & Conditions.

Contact Permission

We'd love to get in touch with you with regards to future Tele-education and other online learning courses. We may need to contact you via email, telephone or post however you can indicate how you would like us to contact you below.
Please note that Email is our preferred method of contact and many of our services such as weekly notification and certification require you to check this box. EmailPhonePost