Enrol on a Course

Which course would you like to enrol the candidate onto?
---Pharmacy Assistant CourseMedicines Counter Assistant Plus Stock Control Course

Candidate Name:*

Candidate Title:*

Candidate Date of Birth:*

Does the candidate have a registered disability?*
NoYesPrefer Not To Say

Does the candidate require any additional support?*
If yes, someone from CIG will contact you to discuss support options.
NoYes

Candidate Ethnicity:*
---Prefer Not To SayWhite BritishWhite IrishCaucasianBlack BritishCaribbeanAfricanAny Other Black BackgroundAsian BritishIndianPakistaniBangladeshiChineseJapanese

Supervisor (Registered Pharmacist/Technician) Name:*

Supervisor GPhC Number:*

Pharmacy Name:*

Pharmacy Address:*

Postcode:*

Telephone Number:*

Email Address:*

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Once you have registered and clicked on the “Submit” button, we will contact you for payment before sending out course materials.