Get The European Board Of Cardiovascular Perfusion

Filling out the application for the Board Examination to obtain the European Certificate in Cardiovascular Perfusion can be a straightforward process with the right guidance. This guide will walk you through each section of the form to ensure you provide all necessary information clearly and accurately.

Follow the steps to complete your application form successfully.

1. Press the ‘Get Form’ button to acquire the application form and open it in an editable format.
2. Begin by completing Section 1, which includes fields for your last name, first names, nationality, and date of birth. Ensure you write clearly in block capital letters and refrain from using abbreviations, except for N/A if not applicable.
3. In Section 2, provide your home and hospital addresses. Include all relevant details such as street, postcode, city, country, telephone number, and email address. Be precise to avoid any delays.
4. Section 3 requires you to specify the language in which you wish to take the examination and list your academic and professional qualifications. Detail your school leaving certificate, vocational training, and degrees/diplomas, along with the year of examination and awarding institute.
5. In Section 4, indicate how long you have been practicing perfusion and record your training program’s name and address. Include the duration of your training course in years and months.
6. Certify your application by having your programme director and the person responsible for your training sign and fill in their names where indicated.
7. Section 5 requires a certification from your employer. Ensure the form is signed by the Personnel Officer/Manager on behalf of the Health Authority. Include any additional address details or stamps if required.
8. In Section 6, write your name as you would like it to appear on the certificate. Avoid any discrepancies with the name provided on the front of the form, and attach a recent photograph where indicated.
9. Section 7 allows you to opt out of sharing your name and hospital address with other perfusion-related organizations. Sign under this paragraph if you choose to keep this information confidential.
10. In Section 8, ensure the examination fee of €160, which covers the certificate if awarded, accompanies your form. Use the attached payment form for this purpose.
11. Review Section 9 carefully to comply with all instructions, as any omissions will result in the return of the form.
12. Conclude in Section 10 by signing to agree to abide by the European Board of Cardiovascular Perfusion’s decisions in case of an appeal and date your signature.
13. After completing the form, ensure all information is accurate, save your changes, and opt to download, print, or share the completed form as needed.

Start filling out your application form online today to take the next step in your professional journey.