Position Applied for: Senior Pharmacist Position Reference No.: NRS3044 Candidate Reference No (office use only) NRS03044 - Personal Details: First Name: Last Name: Postal address for correspondence: MOBILE TELEPHONE (mandatory): Contact Tel No. 2: E-mail Address (mandatory): (You may provide more than one) PPS Number Where did you see this position advertised? Drivers Licence (please state type & category): European Economic Area Are you an EEA (European Economic Area) National? Yes / No Please see Appendix 2 of Additional Campaign Information document for definition of an EEA National. NB If you are a non EEA citizen you must provide the requested documentation to support your application. For further information you must read 2” in the Campaign Information” “Appendix “Additional document. Superannuation Schemes Are you currently in receipt of a pension from any of the following superannuation schemes? (This means have you retired?) YES NO Government Superannuation Scheme (LGSS) Health Service Executive Employee Superannuation Scheme Voluntary Hospital’s Superannuation Scheme (VHSS) Nominated Health Agencies Superannuation Scheme (NHASS)
Position Applied for: Senior Pharmacist Position Reference No.: NRS3044 Candidate Reference No (office use only) NRS03044 - Personal Details: First Name: Last Name: Postal address for correspondence: MOBILE TELEPHONE (mandatory): Contact Tel No. 2: E-mail Address (mandatory): (You may provide more than one) PPS Number Where did you see this position advertised? Drivers Licence (please state type & category): European Economic Area Are you an EEA (European Economic Area) National? Yes / No Please see Appendix 2 of Additional Campaign Information document for definition of an EEA National. NB If you are a non EEA citizen you must provide the requested documentation to support your application. For further information you must read “Appendix 2” in the “Additional Campaign Information” document. Superannuation Schemes Are you currently in receipt of a pension from any of the following superannuation schemes? (This means have you retired?) YES NO Government Superannuation Scheme (LGSS) Health Service Executive Employee Superannuation Scheme Voluntary Hospital’s Superannuation Scheme (VHSS) Nominated Health Agencies Superannuation Scheme (NHASS)
nrs03044---application-form.docx