PROCARE
Cart 0
Home About us Opportunities Blog Counsellor Login Contact Us
Employee Wellness Educational Institutions Individual & Family Counselling Trauma Management Adoptions
Training and Life skills For Companies/Organisations For Educational Institutions
Cart 0
HomeAbout usOpportunities Services Employee Wellness Educational Institutions Individual & Family Counselling Trauma Management Adoptions Training and Life skills Training and Life skills For Companies/Organisations For Educational Institutions BlogCounsellor LoginContact Us
PROCARE

 

PERSONAL INFORMATION
Name *
Residential Address *
Business/Practice Address *
Mobile Number *
Landline/Alternative Number *
Please indicate your registration with Professional Councils and/or other Affiliations (E.g. HPCSA, SACSSP, SAASWIPP, SAMA)
Please rate your computer skills/Level of computer literacy *
How familiar are you with Microsoft Applications, such as Word/Outlook/Excel? *
How familiar are you with Electronic Meeting Platforms, such as MS Teams/Zoom? *
Do you have access to a scanner/copier? *
Do you have a computer with internet access? *
Are you in possession of your own vehicle? *
Do you have your own mobile phone? *
Are you a South African Citizen? *
Have you ever been guilty of a criminal offence? *
Have you ever been found guilty of professional misconduct? *
Are you a registered tax payer? *
Please indicate your language proficiencies
PRIVATE PRACTICE DETAILS (if applicable)
Do you currently have your own practice?
Do you practice on a full-time basis?
EDUCATION
CURRENT EMPLOYMENT (if applicable)
Do you have permission from your Employer to render services to another organisation ?
GENERAL
PERSONAL DOCUMENTATION REQUIRED
CONFIRMATION AND SIGNATURE
I hereby certify that the information supplied is true and completed to the best of my knowledge. Should we have any opportunities available that might fit your profile, you acknowledge that any false or misleading information and documentation provided at any stage, may result in immediate termination of your affiliation with PROCARE. By engaging and/or completing and submitting any documents to PROCARE, you agree to the collection and processing of your personal information for the purpose of attending to your submissions, requests or enquiries. For more information refer to our PAIA/POPIA Manual. If we do not have any suitable opportunities available at this stage that fit your profile, we will not enter into any further communication with you and wish you the very best in your future endeavours. *

Thank you!

 
CONTACT US
 

By engaging and/or completing and submitting any documents on our website you agree to the collecting and processing of your personal information for the purpose of attending to your submissions, requests or enquiries. For more info: PAIA/POPIA Manual