CLIP Application Form

* Required fields

About You
About Your Supporters
Name and title and relationship of supporters.
NB this person should not be your line manager and should be external to pharmacy - see FAQs for advice
About Your Line Manager
  Confirm you have discussed and agreed attendance on the CLIP Programme with your line manager before submitting your application
About Your Work
  You will need to sign up to the Launch Event, all 10 study days and submission of a work-based project, poster and article during the programme. Please tick here to indicate, should you be selected, that you will attend the Launch Event and all 10 study days (unforeseen personal circumstances will be considered if required).
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This site is intended for healthcare professionals or people employed in the pharmaceutical industry. Please confirm that you are such a person.