Course

Name*

First NameLast Name

Email*

example@example.com

Phone Number *

GDC Number*

Job title blanks*

Oral Health Promotion can occur in many environment outside of the traditional surgery. Where do you see Oral Health Promotion having an impact outside of your current working environment?*

What do you think are the major barriers to oral health promotion being viable and sustainable?*

What qualities do you think you can bring to Oral Health Promotion?*

I consent to the content shared in this form to be used for research purposes.

Yes

I consent to be added to the database to receive the Smile Revolution newsletter.

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Submission closing date Sunday 24th October at midnight. Winners announced Tuesday 26th October.

Course beginning on Monday 1st November for 5 weeks, running every Monday and Friday at 6.30pm weekly.

Competition hosted by Smile Revolution, prize supported by Philips. Philips not affiliated with competition T&Cs

Application criteria - applicants must be GDC registered qualified dental professionals.

Selection process - Positive Communications will shortlist all applicants presented annonymously based on the points obtained through the assessment criteria. Victoria will then select the winner based on the assessment criteria in the second phase of the selection process.

Contact will initially be made via email to invite you to a zoom to learn more about the course. Winners will be contacted via email and phone.

Terms and Conditions - http://www.smile-revolution.net/terms-and-conditions/

Please verify that you are human*

Application for fully funded place by Philips