Candidate Registration

If you wish to register with us, please complete the form below ensuring you complete all required details.

Important! Please read the appropriate terms and conditions before you continue with this form! The documents available below are in a PDF format - if you don’t have a PDF reader please download Adobe Acrobat Reader.

Contract for Locums
Interview Regulations - Pharmacists please read before registering.

Agreement

I confirm that I have read and agree to the terms and conditions of contract (Required)

Proof of Identity

We also require a photocopy or scan of your passport or drivers license (and marriage certificate if applicable). If you can supply a proof of identity please inform us of which type you will be sending to us and attach it.

Passport:

Drivers License:

Attach Copy:

Application Details

Job Type: (Required)

If you have chosen Locum Pharmacist, please complete the following details.

RPSGB Number: (this will be validated with the RPSGB) (Required for Locums)

Date Qualified: (Required for Locums)

Do you require dispensing help? (Required for Locums)

Personal Details

First Name (Required)

Surname (Required)

Nationality

Visa No (If Applicable):

Visa Type (if applicable):

Marital Status:

Your Contact Details

Address Line 1 (Required)

Address Line 2

Town (Required)

County (Required)

Post Code (Required)

Country

Telephone No (Required)

Mobile:

Work Tel:

Fax Number:

E-mail:

Job Requirements

Minimum acceptance mileage rate in pence?(Required)

Minimum hourly charge rate? (£) (Required)

Minimum acceptable working hours From? (Required) Minimum acceptable working hours To? (Required)

Maximum hours to work? (Required)

What computer systems do you regularly use? (Required)

Travel

Please let us know of your preferred locations.

Location 1

Location 2

Location 3

Location 4

Location 5

Driving License:

Own Transport:

Referee 1

Name: (Required)

Company:

Address 1: (Required)

Address 2:

Town: (Required)

County:

Postcode: (Required)

Telephone: (Required)

Referee 2

Name: (Required)

Company:

Address 1: (Required)

Address 2:

Town: (Required)

County:

Postcode: (Required)

Telephone: (Required)

Your CV/Resumé

Please make brief notes outlining your Qualifications, Experience, Pharmacies in which you would prefer to be placed and any dates in which you are looking for placements.

I do not wish to receive further notifications from New Directions Professional Ltd

Attach your CV/Resumé in Word or Text Format if available:

Qualifications & Accreditations

For Pharmacists: Please browse for and upload any certificates you have for the following CPD / accreditations.

Repeat Dispensing:

CPPE:

MUR:

Supporting Care Homes:

Emergency Hormonal Contraception:

Patient Medication Records:

Other: (please state and upload)

Upload File:

Please keep us updated if you gain any further accreditations.

Clincal Diploma:

Supplementary Prescriber:

Other: (please state and upload)

Upload File:

Please keep us updated if you gain any further Additional Qualifications.

Professional Indemnity Insurance

We also require proof of your Professional Indemnity Insurance.

Please advise of your policy number:

Effective From:

To:

Please upload the certificate so we can keep on file.

Please notify us of any changes to your membership.