Inter / Intra Deanery Transfer - East of England Multi-Professional ...

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Inter-Deanery Transfer Application Form Last name: First name: To be completed by current Postgraduate Dean: Do you approve and support this trainee‟s application for a transfer? YES NO If NO, please give reasons: This trainee currently holds a National Training Number (NTN) YES NO If YES I would prefer that this NTN: is retained for the duration of his/her programme be retained for an interim period and then relinquished is relinquished and that you issue a (receiving deanery) NTN Signature ………………………………………………………………. Date / / NAME DEANERY To be completed by receiving Postgraduate Dean: Select 1 of the following options Yes, I confirm I can accept this transfer request with effect from Start date: / / No, I am not willing to accept this transfer request for the reason given below I am unable to accept at this time but would accept the transfer if a vacancy subsequently becomes available Inter / Intra Deanery Transfer Policy East of England Multi-Professional Deanery Updated January 2012 - 12 - Please tick Please tick Signature ………………………………………………………………. Date / / NAME DEANERY
FORM GP IDT1 Inter-Deanery Transfer Application Form Please complete this form in BLOCK CAPITALS and Black Ink and submit to your current DPGPE. Approval of an inter- Deanery transfer application does not guarantee a placement in another deanery. Please ensure you have read the guidance notes relating to Inter-Deanery Transfer applications. Current Deanery: GMC Number: Proposed Deanery: dd mm yyyy Date of Proposed Transfer: (you are advised to apply before recruitment to this intake has commenced) CONTACT DETAILS: Last name: First name: Current Address: for correspondence Postcode: Telephone No: Fax No: Mobile telephone: Email: CURRENT GP ST SCHEME: Name of ST Scheme: Date of Appointment to GP VTS: CURRENT POST: ST Specialty: GPR Practice: dd mm yyyy Full time Part time Expected date of completion of GP VTS: Start date: Finish date: PROPOSED POST: Please tell us if you have posts planned that you have not started yet ST Specialty: GPR Practice: Full time Part time Start date: Finish date: Inter / Intra Deanery Transfer Policy East of England Multi-Professional Deanery Updated January 2012 - 13 - dd mm yyyy POSTS COMPLETED AS PART OF GP Specialty Training Programme: Enclose the appropriate VTR2 forms Specialty: Full time Part time Full time Part time Full time Part time Full time Part time Start Date End Date dd mm yyyy dd mm yyyy
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Inter / Intra Deanery Transfer - East of England Multi-Professional ...

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