Pharmacist/PA Candidate Profile

Personal Details

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1. Please specify which position are you applying for - e.g. Pharmacist Position Nelspruit (Required.)

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2. Where did you hear about this position? (Required.)

Pharmacy Connect Email

Facebook - PharmacySA group

Facebook - Pharmacy Connect's page

Word of mouth

Pharmacy Connect website

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3. Personal Details (Required.)

First Name

Surname

Personal e-mail address

Work e-mail address

Cell no

What city & province do you live in currently?

South African Citizen (Yes/No)

Racial Group (Black African/White/Coloured/Indian or Asian)

English proficiency (Speak/Read/Write)

Afrikaans proficiency (Speak/Read/Write)

Other language proficiency

Willing to travel more than 50km a day (Yes/No)

Willing to relocate to another province (Yes/No)

Your age

Gender

Do you have your own transport/vehicle?

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4. Current Professional Details (Required.)

Employment Status (Permanent/Locum/Unemployed)

Availability to Start New Position (dd/mm/yyyy)

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5. Pharmacy Registration Information (Required.)

Are you a Pharmacist (Yes/No)

Are you a Basic PA (Yes/No)

Are you a Post Basic PA (Yes/No)

Do you have a Grade 12 certificate? (Yes/No)

South African Pharmacy Council Registration P Number

Registration Status (Active/Inactive/Suspended/Retired)

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6. Tertiary Education (Required.)

First Qualification (Degree name)

Second Qualification (Degree name)

Any other courses (e.g. Diploma/Degree)

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7. PCDT (Primary Care Drug Therapy) Course (Required.)

I have successfully completed the PCDT Course

I am busy studying to become a PCDT Pharmacist

I would like to study to become a PCDT Pharmacist

Other (please specify)

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* 1. Please specify which position are you applying for - e.g. Pharmacist Position Nelspruit (Required.)

Question Title

* 2. Where did you hear about this position? (Required.)

Question Title

* 3. Personal Details (Required.)

Question Title

* 4. Current Professional Details (Required.)

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* 5. Pharmacy Registration Information (Required.)

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* 6. Tertiary Education (Required.)

Question Title

* 7. PCDT (Primary Care Drug Therapy) Course (Required.)

1. Please specify which position are you applying for - e.g. Pharmacist Position Nelspruit (Required.)

2. Where did you hear about this position? (Required.)

3. Personal Details (Required.)

4. Current Professional Details (Required.)

5. Pharmacy Registration Information (Required.)

6. Tertiary Education (Required.)

7. PCDT (Primary Care Drug Therapy) Course (Required.)