Request for Information - The Hospital for Sick Children

Request for Information Application

To learn more about International Education services, please complete the online application form. Once we receive your application, a member of our team will contact you to explore how we can tailor our programming to meet your learning needs.

1. Contact Information

Title:

Name:

First

Last

Position:

Email:

Phone

2. Organization Information

Organization Name:

Organization Address:

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email: your provide

Please provide a brief description about your organization.

3. Request Details

Have you or your organization collaborted with SickKids in the past? if yes, please explain.

Please identify the learning objectives you or your organization wish to address.

Please identify the direct and indirect beneficiaries of this collaboration (For example: nurses, doctors, patients, etc.)

Have other SickKids stakeholders been consulted? If yes, please state the SickKids staff name(s) and department(s).

Please allow 3-5 business days to process your application. Once your application has been reviewed, you will be contacted for further information.

Your personal information is collected under the authority of the Public Hospitals Act R.S.O 1990, c. P.40 and will be used by SickKids for the purpose of evaluating your suitability for acceptance into the International Learner Program. In the event that we move forward with your application, your personal information may be disclosed to SickKids staff involved in planning your learning experience.By submitting this application you consent to the above collection, use and disclosure of your personal information by SickKids. Questions about the collection of your personal information can be directed to the Privacy Office: 555 University Avenue , Toronto, Ontario, M5G 1X8, (416)813-6190 or privacy.office@sickkids.ca.

I represent and warrant to SickKids that all of the personal information about me that I am submitting to SickKids is complete and accurate.

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