Employment Application

1
Phone Number* This field is required.Your primary phone number via which we can contact you
Must contain 10 digits
2
Identity NumberThis will be kept private and confidential
Must contain 13 numbers
3
Email* This field is required.
example@example.com
4
Which of these positions are you applying for?* This field is required.Select one or more of the positions that you are interested in below
Operational Emergency Services Staff
Event Medical Staff
Volunteer (Operations or Events)
Operations Control Centre Dispatcher/ Call-taker
Training Instructor/ Facilitator
Administration/ Secretarial Staff
Managment/ Coordinator/ Supervisor Positions
Debt Collector
Executive Personal Assistant
Other
5
Your Current Qualification* This field is required.You must be registered with the HPCSA or SANC as having the qualification you select below
Basic Ambulance Assistant (BAA)
Ambulance Emergency Assistant (AEA - ANA)
Critical Care Assistant (CCA - ANT)
National Diploma Paramedic (NDip - ANT)
Diploma Paramedic (DipEMC - ANT)
Emergency Care Assistant (ECA)
Emergency Care Technician (ECT)
Emergency Care Practitioner (BTech/ BEMC/ BHSc) (ECP)
Enrolled Nurse (EN - SANC)
Registered/ Professional Nurse (RN - SANC)
Medical Practitioner (MBChB/ MBBCh/ MBBS) (MP)
No Medical Qualification
Student/ International/Visiting Student (Volunteer only)
Other
6
Your Current HPCSA/ SANC Registration Number* This field is required.
Leave Blank if Not Applicable
7
What Other Qualifications Do You Have?* This field is required.Any current qualifications and certificates that you believe are relevant
8
Do you have a Professional Driver's Permit for Passenger Transportation?* This field is required.
Yes
No
9
Curriculum Vitae* This field is required.Please Upload your CV in PDF Format - Please ensure the uploaded document is in good condition and ledgible
Drag and drop files here
Select files to upload
Min. file size1.0KB, Max. file size: 10.0MB
PDF Format only, May not exceed 10MB
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10
Identity Document or Passport* This field is required.Please ensure the uploaded document is in good condition and ledgible
Drag and drop files here
Select files to upload
Max. file size: 4.9MB
Size may not exceed 5MB
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11
HPCSA or SANC Card/Proof of registration* This field is required.Please ensure the uploaded document is in good condition and ledgible.
Drag and drop files here
Select files to upload
Max. file size: 4.9MB
Size may not exceed 5MB
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12
Driver's Licence* This field is required.Please ensure the uploaded document is in good condition and ledgible.
Drag and drop files here
Select files to upload
Max. file size: 4.9MB
Size may not exceed 5MB
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13
Your Full Name* This field is required.
First Name
Last Name
Should be Empty: