PESCI application form

Transcription

PESCI application form
Please email to: [email protected]
Or mail to: Australian Medical Review
Centre
ABN: 49 159 636 049
Level 1, 7-9 Churchill Avenue
Strathfield, NSW 2135
Ph: (02) 9007 4235 or 045 045 8086
PESCI WORKSHOP
Application Form
Date: 22 March 2015
Fee: $350
The PESCI Workshop is designed to aid those who have a job offer or are in the process of looking for work. The course
aims to:
•
•
•
Explain the PESCI, its contents, process and format
•
Give candidates a chance to practice and participate in interviews and roleplays.
Help candidates prepare for PESCI-style questions
Allow candidates to adjust and improve their clinical consultation skills
______________________________________________________________________________
Name:_________________________________________________________________________
Address: ______________________________________________________________ ________
Suburb: _________________
___State: ________________________Postcode:____________
AMC Candidate number: __________________________________________________________
Phone/Mobile number: ___________________Email Address: ____________________________
Payment method:
o Online Transfer:
Account Name: Australian Medical Review Centre Pty Ltd.
Account Details:
BSB – 032 028
Account number – 376 081
Bank Name: Westpac Banking Corporation
Branch: Haymarket, Sydney Branch
Swift code: WPACAU2s
Reference: Your Name
o Credit Card
You may request for a credit card authorization form. Please note that credit card
transactions are subject to 2.4% surcharge.