JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
R346A - Fieldworker (x2)
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Job advert reference number
*
Please enter the job advert reference number
Your answer
First Name
*
Your answer
Surname
*
Your answer
ID Number
*
Your answer
Email Address
*
Your answer
Contact Number
*
Your answer
Race
*
African
Coloured
Indian
White
Non South African Resident
Gender
*
Female
Male
Do you have any disabilities?
*
Yes
No
Do you have a valid Code 8 (B) driver’s licence?
*
Choose
Yes
No
Do you have a matric certificate?
*
Yes
No
How many years of experience do you have as a fieldworker?
*
None
1 Year
2 Years and more
Kindly select the languages that you are able to speak, write and read (fluently):
*
Afrikaans
isiXhosa
English
Required
Are you computer literate?
*
Yes
No
Do you reside near Kraaifontein CHC and be able and willing to use public transport to travel to the health facility?
*
Yes
No
Do you have your own transport to commute to the CHC?
*
Yes
No
Do you have experience working in a research setting, which includes recruiting participants and other fieldwork activities for clinic-based research projects?
*
Yes
No
Where did you see this advert?
*
SAMRC Website
SAMRC Facebook
LinkedIn
Newspaper
Word of Mouth
Other:
List current or previous work experience and other relevant information:
*
Should be 2000 characters or less
Your answer
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This form was created inside of South African Medical Research Council.
Report Abuse
Forms
