IPAC Canada Essentials in Infection Prevention and Control Course
Accelerated Program beginning April 2024.

Online Application Form

APPLICANTS MUST ONLY APPLY FOR ONE COURSE OFFERING AT A TIME
(Accelerated Course, OR the Regular Course)

Please complete all information in this form, and upload your Application Form, current C.V. or resume, and your Employer Letter of Support. (Ensure you have all files saved and ready to upload before proceeding).

1. Download and complete the Accelerated Course Application Form and the Employer Letter of Support, which you can find at the bottom of our course webpage, available at this link
   
   The Application Form is a fillable Word document; however save your completed form as a PDF using the file name format LASTNAME_FIRSTNAME_APPLICATION.pdf. 
    
2. Save your current C.V./resume as a PDF using the file name format LASTNAME_FIRSTNAME_RESUME
    
3. Save your Employer Letter of Support as a PDF using the file name format: LASTNAME_FIRSTNAME_EMPLOYERSUPPORT
    
4. Complete the following online application form (enter your given name (no nicknames) and your HOME address, upload your documents, and click 'Submit'. You will receive an automatic reply to indicate your application was submitted. If you do NOT receive the auto-reply, please email admin@ipac-canada.org to inquire if your application was received. DO NOT submit a duplicate application unless we advise you your application was not received.

The deadline for applications is March 18, 2024. A course overview and requirements can also be seen at the above link. Applicants will be advised of their acceptance by March 24, 2024. E-notifications regarding acceptance will come from the course coordinators' email, basicde@ipac-canada.org - add this as a 'safe sender' to your Address Book. Accepted students will be sent instructions on remitting tuition fees in full, which are due by March 31, 2024.

If you are not accepted into the Accelerated Course, you may re-apply to the Regular Course if you wish. (Employer Letter of Support not required for the Regular Course.)

Title

First Name*

Last Name*

Address*

City*

State/Province*

Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip/Postal Code*

Country*

Canada United States Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cabo Verde Cambodia Cameroon Canada Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo (Democratic Republic of the) Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea (Democratic People's Republic of) Korea (Republic of) Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestine, State of Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan, Province of China Tajikistan Tanzania, United Republic of Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands (British) Virgin Islands (U.S.) Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe

Email Address*

Phone*

Are you currently a practicing infection control practitioner - or transitioning into an ICP role?*

Yes

No

What is your current work environment? Choose one from the drop-down menu:*

acute carelong term carecommunity healthpublic healthlaboratorydentaloccupational healthother

If work environment is 'other' please specify:

Are you currently a member of IPAC Canada?*

Yes

No

Upload your completed Course Application Form in the format LASTNAME_FIRSTNAME_APPLICATION.pdf*

 

Upload your resume using the file format LASTNAME_FIRSTNAME_RESUME*

 

(Accelerated Program Applicants Only): Upload your Employer Letter of Support as LASTNAME_FIRSTNAME_EMPLOYERSUPPORT*

 

Enter the code displayed*