BOOK A VIRTUAL COURSE

Sirius Training Bookings Request - virtual course

Invicta Health Course Reference
Course Type*
Other (Please enter the training you require)
Details of person making the booking
Name*
First Last
Job Title
Email*
Enter Email Confirm Email
Phone*
Mobile Phone/Direct Dial
Please supply a direct dial or mobile number so that we can contact you direct without the need to go through automated call answering, messages and queues . (particularly if you are a medical or dental practice).
Alternative Contact, Name, Email and Telephone
Please provide name, email address and telephone number of an alternative contact should you be unavailable.
Practice/Organisation Name*
Please enter the name of your Practice, Business or Organisation.
PCN
Surgery G Code
Contact Address
Street Address Address Line 2 City ZIP / Postal Code
Number of Delegates (from your Practice)*
Please enter a number from 1 to 20.
PLEASE NOTE: THE MAXIMUM NUMBER FOR A VIRTUAL SESSION IS 20. The number entered has to be a whole number, not 12-20 or approx 16. If you have more than 20 Delegates additional sessions will be required.
Email Address for Invoice*
Enter Email Confirm Email

We now supply invoices by email. Please enter the email address to where invoices and statements should be sent. This may be an individual email address or a generic email address for your accounts department.
Delegate Details
Maximum on each course is 20 Delegates. Please press "+" to the right of the delegates email address to open an entry for the next delegate. PLEASE NOTE AN INDIVIDUAL EMAIL ADDRESS IS REQUIRED FOR EACH DELEGATE - DO NOT SUBMIT THE SAME EMAIL ADDRESS FOR EVERYONE.
List of Delegates
Delegate Names (as they will appear on certificates). You must provide an individual email address for each delegate. Click on "+" to enter fields for additional delegates. PLEASE ENSURE THERE ARE NO ERRORS IN NAMES AND EMAIL ADDRESSES ARE ENTERED CORRECTLY - errors may lead to delegates not getting a certificate or charges incurred for corrections to be made.
First Name Last Name Job Title Email
Untitled
not required, but to match field on NHS kent form
Suggested dates of training in order of preference
Please note for Primary Care Practices, PLT days get booked up early and for Schools Inset days get booked up early, so availability may be limited, please therefore provide a selection of dates.
Date Choice 1*

Please supply a selection of dates. Please note for Primary Care Practices PLT dates and for Schools Inset dates, get booked up very early and it is not always possible to offer training on your first choice date. If you have a large group (over 20 delegates), please provide information in the any other comments field below as to whether you are looking to train everyone on one day or over several sessions on different dates.
Date Choice 2
Date Choice 3
Start Time (24 hour clock)*

: Hours

Minutes
Any other comments?
Please provide any specific requirements here, such as multiple sessions over separate dates, or multiple sessions on the same day. Or any other information we may need to make your booking.
I confirm that I ...*
- have read the course details in the booking email. I note the length of session, that this is formal training and may include a written assessment. I accept that delegates must be present for the entire session and successfully complete any written assessment to be awarded the appropriate certificate
- accept the terms and conditions of booking published on the Sirius Business Services Ltd website and that cancellation charges may apply should the training be cancelled
- acknowledge all delegates must have and supply a working email address and have access to a PC, Mac book, IPAD, Android PAD or a smart phone. All delegates must have a working camera and microphone on their device and the camera must remain live for the duration of the training and all delegates must remain visible on camera throughout the training.
Signed (type name)*
Date*
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