Name: PsychMed
Address: Level 1 Bagot House, 198 North Terrace, Adelaide, South Australia, 5000, Australia
Telephone: 08 8232 2424
Price range: $$

Name*
First Last
Email*
Phone*
Address*
Street Address Suburb State Post Code
Date of birth*

Day
Month
Year
Current Drivers License?*
- Yes
- No
Own Vehicle/Transport?*
- Yes
- No
Current DCSI Clearance or National Police Clearance?*
- Yes
- No
Consent*
I acknowledge/understand if I do not that it is a requirement to obtain one before commencing employment with PsychMed.*
References*
Please provide us with two current references (for internships and finance officers it is preferable for one employment and one academic reference to be provided):
Name Organisation/Institute Phone Number
Position Applied For:*
- Clinical Psychologist Associate
- Clinical Psychologist Registrar
- Internship
- Administration
- Finance Officer
Do you have a demonstrated commitment, interest or relationship to/with rural Australia?*
- Yes
- No
Please describe.*

Documents to upload:
100 Points of ID*
Drop files here or

Accepted file types: jpg, jpeg, png, pdf, doc, docx, Max. file size: 2 MB.
Maximum file size 2MB, files allow are - jpg,jpeg,png,pdf,doc,docx
Resume*
Drop files here or

Accepted file types: pdf, doc, docx, Max. file size: 2 MB.
Maximum file size 2MB, files allow are - pdf,doc,docx
Cover Letter*
Drop files here or

Accepted file types: pdf, doc, docx, Max. file size: 2 MB, Max. files: 1.
Maximum file size 2MB, files allow are - pdf,doc,docx
Academic transcript (can be unofficial) or relevant certificate*
Please also attach a copy of your academic transcript (unofficial transcript is acceptable with predicted mark where possible) Maximum file size 2MB, files allow are - pdf,doc,docx
Drop files here or

Accepted file types: pdf, doc, docx, Max. file size: 2 MB, Max. files: 1.

Name	Organisation/Institute	Phone Number

Apply for a career with PsychMed