Vet Nurse Registration Form - Vet Jobs with VetStaff

PRACTICE PREFERENCE
Where in New Zealand would you prefer to live / work?*
please select as many places / cities / regions as you would like
What type of practice would you prefer to work in?*
- Small / Companion Animal
- Lifestyle
- Dairy
- Beef / Sheep / Deer
- Equine
- Exotic
- Medicine Only
- Routine Surgery
Complex Surgery Details
please elaborate on any complex surgery information you'd like us to know about.
Special Interests / Specialties
please elaborate on any special interests and/or specialties you'd like us to know about
Post graduate courses undertaken & additional qualifications
please tell us about further post-grad studies you've undertaken here
Minimum / maximum periods you’ll undertake locum position(s) for*
Do you have special conditions regarding locum work it's important for us to know about?

Hourly / Daily Rate*

Hourly Rate	Daily Rate

Your Existing Client Clinics
Please list any clinics you've previously locumed at so we don't approach these clinics on your behalf.
What jobs have you already applied for and/or clinics have you submitted your CV to in the last two months? What was the outcome of each of these applications?*
Please use a new line for each clinic / job. If you've applied through Seek or Trade Me please list the job references (if possible).

Name	Contact Tel No	Email Address	Relationship

Name	Contact Tel No	Email Address	Relationship

Name	Contact Tel No	Email Address	Relationship

Emergency Contact Person