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).

You will receive the outcome of you application within 5-7 business days via email.

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?

YesNo

2. Have you completed one year of clinical practice (equivalent to 2,080 hours)?

YesNo

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)

Phone Number

Are you of Aboriginal or Torres Strait Islander origin?

YesNoPrefer not to say

Address

City

Postal Code

Contact Information