Immunisation Application Form
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To be eligible for admission into Immunisation course, you must be a
AHPRA
Registered Division 1 Nurse with General Registration
and must have completed at least one year of clinical practice (equivalent to 2,080 hours)
.
1. Are you a AHPRA Registered Nurse Division 1 with General Registration and a current Unrestricted Registration with the Nursing and Midwifery Board of Australia?
Yes
No
2. Have you completed one year of clinical practice (equivalent to 2,080 hours)?
Yes
No
You are ineligible for this program.
Proof of Experience
Upload a Proof of Experience document (e.g. Letter from employer/HR record)
(Click the 'Browse' button to select a file)
Personal Details
First Name
Last Name
AHPRA Registration
Date of Birth (DD/MM/YYY)
Email
Phone Number
Are you of Aboriginal or Torres Strait Islander origin?
Yes
No
Prefer not to say
Address
City
Postal Code
Contact Information