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Applicant Information
Service Type:
Centre Registration
Centre:
City:
Email Of Representative Hosted Hospital:
Mobile: "+966"
List 3 – 5 Objectives of Your TOT-Go Workshop:
List Your Target Audience:
Note: You have to select two consecutive days
Indicate the Target Date (s):
Select a date
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The selected date must be at least two weeks before the actual date - يجب ان يكون الموعد المدخل قبل الموعد الفعلي بأسبوعين
Method of Delivery:
Describe in Less Than 300 Words How Can You Ensure the Effectiveness of The Workshop:
Describe in Less Than 300 Words How Can You Ensure the Authenticity and Protect the Intellectual Property of The Material Involved:
Describe in Less Than 300 Words How This Workshop Fits in Your Residency/Postgraduate Training Curriculum, Framework Objectives and Outcome Competencies (CanMEDS, SaudiMEDS, etc.):
Describe in Less Than 300 Words How to Monitor The Positive Impact of The Workshop on The Daily Practice of The Participants:
Describe in Less Than 300 Words How This Workshop Fits in Your Overall Faculty Development Program:
Describe in Less Than 300 Words How This Workshop Will Help Achieve Better Public Health and Well-Being:
Please Declare Any Conflict of Interest:
An official letter from DIO must be attached
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Facilitators / Co-Facilitators
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Facilitators / Co-Facilitators?
SCFHS Approval
Facilitator Name
CV
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Please select atleast one value from the list.
Declaration:
I declare that all the information provided in this form is correct, I commit to provide one seat for SCFHS Evaluator to during the workshop and I commit to providing a report on the workshops within 2 days after conducting including a detailed list of the participants and their specialties and share with the participant the post-workshop satisfaction survey of the SCFHS.
 
Verification Code
Please Check the Confirmation Code:
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Your Application has been submitted successfully . Your request number is تم تقديم طلبك بنجاح. ​رقم طلبك هو الرجاء تعبئة الحقول الالزامية Please fill the missing fields to continue your process. No result found ! لا يوجد نتائج !