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KP BBS Survey Nurse Form
Please complete this form as part of your application for the above mentioned position.
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* Indicates required question
Email
*
Your email
Please enter your name and surname
*
Your answer
Highest qualification:
*
PhD
Masters
Degree
Diploma
Certificate
Valid Nurses’ Council of Zimbabwe practising certificate:
*
Yes
No
Valid rapid HIV testing certificate
*
Yes
No
Describe your work experience
*
Your answer
Research experience
*
1 to 2 years
2+ to 4 years
5 years or more
Experience with Key Populations?
*
Yes
No
Please give a brief description of the work you did with key populations:
Your answer
Previous BBS experience:
*
Yes
No
Please give a brief description of your previous BBS role if applicable:
Your answer
Do you have prior experience with electronic data capturing tools?
*
Yes
No
Languages you are fluent in?
*
English
Shona
Ndebele
Required
Preferred survey site:
*
Harare
Bulawayo
Gweru
Masvingo
Mutare
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