Registration for Locum

Health Stores Ireland Locum Database

Please complete the questionnaire below, giving as much detail as possible, to be stored in the Health Stores Ireland Locum Database which will be available (only on request) to IAHS members.   
1.What type of locum work are you interested in?
2.What geographical area are you willing to cover?
3.What are you looking for in return for your cover?
4.What is the goal of your placement?
5.What dates and time periods suit you best?
6.Please give a brief summary of your retail experience and any specific expertise you feel you can offer 
7.Please supply a name and details for a reference
8.Your name, address and contact details (not disclosed without consent)
9.Privacy Disclaimer. By ticking this box I consent to the information I have provided being shared within Health Store Ireland. I understand that this information may be inadvertently shared with third parties.(Required.)