Placement Intention Form for 2016

Congratulations on being made a placement offer for your 2016 placement. GP Registrars must notify NTGPE of their placement intention for 2016 by filling out the below details. Upon receiving this information we will get back to you within two business days to confirm the suitability of the placement.

  • For 6 months placements at two different Training Posts in Term 1 and Term 2 you are required to complete two separate Placement Intention Forms.Placement Intention Forms are to be completed and submitted separately on receipt of offer.
  • For a 12 months placement at the same Training Post you are required to complete one Placement Intention Form on receipt of offer.

Requested Training Location (the name of the clinic, clinic address and region) e.g Cavenagh Medical Centre, Darwin.

If you have identified this as a part-time position please indicate how many FTE days you will be working including practice based teaching and on which days?

Please indicate your commencement date below.
If your commencement dates are different to the Terms indicated below please indicate your dates and the reason

Term 1 - 18/01/2016 to 17/7/2016

Term 2 - 18/7/2016 to 15/1/2017