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This form can only be completed by the signatory of the Foot Care Nurse Curriculum Agreement or, in the case of colleges, universities and health agencies, their designated primary contact, if identified by the signatory of the agreement by use of this form.
I, the Educator, am requesting Educator’s Corner access for my Team Member.
REQUEST BEING SUBMITTED BY (EDUCATOR):
Referred to in this form as the “Educator” (Foot Care Nurse Educator, or a college, university, or a health agency with a license to use and access Foot Canada Training’s “Curriculum Program”).
REQUEST BEING SUBMITTED FOR (TEAM MEMBER):
Referred to in this form as the “Team Member” (an employee or contractor working for the Educator).
PRIMARY CONTACT DESIGNATION: This request can only be completed by the signatory of the Curriculum License Agreement for a college, university or health agency.
TIME RESTRICTIONS:By submitting this form I, the Educator, understand that access will be granted for the duration of the curriculum license. Should the Team Member leave my team and/or no longer require access, I will notify Foot Canada Training immediately.
By submitting this form I confirm that I am aware of all the terms listed of my signed Foot Care Nurse Curriculum Agreement with Foot Canada Training, including Schedule A & B.
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Providing nursing foot care education since 1993