{"id":706,"date":"2015-03-18T11:23:05","date_gmt":"2015-03-18T10:23:05","guid":{"rendered":"http:\/\/www.newportphototherapytraining.co.uk\/?page_id=706"},"modified":"2024-12-07T13:33:26","modified_gmt":"2024-12-07T12:33:26","slug":"online-application-form","status":"publish","type":"page","link":"https:\/\/www.newportphototherapytraining.co.uk\/?page_id=706","title":{"rendered":"Online Application Form"},"content":{"rendered":"<h3><a href=\"\/\/www.newportphototherapytraining.co.uk\"><span style=\"color: #800080;\"><span style=\"color: #999999;\">&lt; Return to Newport Phototherapy Training Home Page<\/span><\/span><\/a><\/h3>\n<p><span style=\"color: #ffffff;\">.<\/span><\/p>\n<h1 style=\"text-align: center;\"><span style=\"color: #3366ff;\">ONLINE COURSE APPLICATION FORM<\/span><\/h1>\n<p><strong>Please complete all sections.<\/strong><\/p>\n<p>(<strong>NB:<\/strong> see <span style=\"color: #800080;\"><a style=\"color: #800080;\" href=\"http:\/\/www.newportphototherapytraining.co.uk\/?page_id=56\">How to Apply<\/a><\/span> for Terms and Conditions of booking your place)<\/p>\n<p>In addition to your own details, if your employer or sponsor is financing your place, please provide their address details in the &#8216;Funding Contact Name and Address&#8217; section. We will send the invoice to the addressee indicated.<\/p>\n<p><strong>A copy of the form will be forwarded to your email address for your records. If appropriate, please pass this to the person responsible for arranging the funds for your place. IMPORTANT: Please let us know if your organisation needs to raise an order number in order for us to issue the invoice for your place.<br \/>\n<\/strong><\/p>\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f380-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"380\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F706#wpcf7-f380-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"380\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f380-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<p>Your Full Name:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span>\n<\/p>\n<p>Your Job Title:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"JobTitle\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"JobTitle\" \/><\/span>\n<\/p>\n<p>Organisation:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"Organisation\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"Organisation\" \/><\/span>\n<\/p>\n<p>Address and Postcode:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"add1\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"add1\" \/><\/span>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"add2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"add2\" \/><\/span>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"add3\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"add3\" \/><\/span>\n<\/p>\n<p>Your Email\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span>\n<\/p>\n<p>Contact Number (the best telephone number we can use to contact you regarding your course application)\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"tel-612\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"tel-612\" \/><\/span>\n<\/p>\n<p>Please select the course:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"menu-209\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"menu-209\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"2026: 6-8 June 2026: Phototherapy and PUVA (3 Days)\">2026: 6-8 June 2026: Phototherapy and PUVA (3 Days)<\/option><option value=\"2026: 26-28 September 2026: Phototherapy and PUVA (3 Days)\">2026: 26-28 September 2026: Phototherapy and PUVA (3 Days)<\/option><option value=\"2026: 13 October 2026: Phototherapies Update (1 Day)\">2026: 13 October 2026: Phototherapies Update (1 Day)<\/option><option value=\"2026: 7-9 November 2026: Phototherapy and PUVA (3 Days)\">2026: 7-9 November 2026: Phototherapy and PUVA (3 Days)<\/option><\/select><\/span>\n<\/p>\n<p>Who should be invoiced for your place?\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"radio-104\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><span class=\"wpcf7-list-item-label\">Self-funding<\/span><input type=\"radio\" name=\"radio-104\" value=\"Self-funding\" \/><\/span><span class=\"wpcf7-list-item last\"><span class=\"wpcf7-list-item-label\">Invoice to your employer\/sponsor<\/span><input type=\"radio\" name=\"radio-104\" value=\"Invoice to your employer\/sponsor\" \/><\/span><\/span><\/span>\n<\/p>\n<p>- - - - FUNDING CONTACT NAME AND ADDRESS - - - -\n<\/p>\n<p>If you are funded by an employer\/sponsor, it is important you include their name and address details below (NB: Full payment is due 8 weeks prior to the start date so if your Trust generates their own purchase order number, an invoice can only be issued once the PO number is received. Please check with your employer first.)\n<\/p>\n<p>Finance Contact Name (*Required Information* - if you are self-funding please type 'As Above'):\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"text-150\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-150\" \/><\/span>\n<\/p>\n<p>Address and Postcode:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"text-191\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-191\" \/><\/span>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"text-574\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-574\" \/><\/span>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"text-986\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-986\" \/><\/span>\n<\/p>\n<p>** [NB: If you do not receive a copy of your application by email after you submit, please contact the Course Administrator to confirm your place has been reserved]. **\n<\/p>\n<p>Your Message (optional)\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-message\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"your-message\"><\/textarea><\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>&lt; Return to Newport Phototherapy Training Home Page . ONLINE COURSE APPLICATION FORM Please complete all sections. (NB: see How to Apply for Terms and Conditions of booking your place) In addition to your own details, if your employer or sponsor is financing your place, please provide their address details in the &#8216;Funding Contact Name [&hellip;]<\/p>\n","protected":false},"author":28,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-706","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.newportphototherapytraining.co.uk\/index.php?rest_route=\/wp\/v2\/pages\/706","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newportphototherapytraining.co.uk\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.newportphototherapytraining.co.uk\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.newportphototherapytraining.co.uk\/index.php?rest_route=\/wp\/v2\/users\/28"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newportphototherapytraining.co.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=706"}],"version-history":[{"count":17,"href":"https:\/\/www.newportphototherapytraining.co.uk\/index.php?rest_route=\/wp\/v2\/pages\/706\/revisions"}],"predecessor-version":[{"id":1077,"href":"https:\/\/www.newportphototherapytraining.co.uk\/index.php?rest_route=\/wp\/v2\/pages\/706\/revisions\/1077"}],"wp:attachment":[{"href":"https:\/\/www.newportphototherapytraining.co.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=706"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}