FPS ST Scholarship EOI form

Last updated 17 April 2024

Submit an expression of interest

* denotes required field

Name:*

Email:*

RACGP ID:*

Modified Monash Model (MMM) area:*

Suburb or town of practice:*

I have completed MHST Level 1 (please advise date completed):

I currently use FPS in my practice (please advise number of cases):

Preferred intake:*

Declaration:*

I declare that:

I will be able to complete all four course modules and agree to the intake date.
I have read and accept the Terms and Conditions.

I agree

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