Job Application

Medical Professionals Application Form

Registered Nurses • Physicians • Allied Health Professionals

Healthcare Professional Application Form

have Updated etc.)

Full Name

First

Last

Mobile Number

Email Address

Current Address

Position Applying For

PRC License Number

PRC License Expiry Date

Upload PRC ID Image/PDF

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For Registered Nurses - Do you have BOSH Basic Occupational Safety and Health Training for Nurses

For Physicians - Are you a PCOM Member or do you have PCOM Certification

Other Certifications (optional upload)

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Years of Clinical Experience

Previous Roles / Work Settings (corporate clinic, hospital, BPO, manufacturing etc.)

Are you willing to be assigned to corporate or industrial sites

Desired Work Schedule

Earliest Available Start Date

Updated CV / Resume

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Training Certificates (optional)

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Government IDs (optional)

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CONSENT

I certify that the information I have provided is true and complete. I consent to the collection and processing of my personal data for evaluation of my application, in accordance with applicable privacy laws and Affinity Medical’s data protection policies.