Expression of Interest

Are you interested in offering an APPEL placement?

APPEL4th Year Placement Expression of Interest

If you would like to register your Training Establishment to offer APPEL placements, please complete this form.

If your Training Establishment does not have a PSI registration number, please enter 0
If Dublin, please include district, eg. Dublin 2. Please avoid using city areas eg. Rathmines instead of Dublin 6 or Togher instead of Cork.
Practice Area
The e-mail address of the person best contacted by APPEL regarding these placements. Note that this will not be visible to students in the matching process.
Please separate area code with dash, eg. 085-1234567. Note that this will not be visible to students in the matching process.
Please confirm your consent to be contacted by APPEL
Do you have a PSI registered pharmacist available within the organisation to act as Preceptor ?
How many 4th-Year placements is this Training Establishment offering? A Preceptor can supervise up to 3 students at the same time.
If you have any further information you would like us to know about your Training Establishment, please enter it here.