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Application Form
 

For any queries or assistance in filling out this form please contact the Faculty of Health Sciences HR team on (07) 3346 5310.
School
Application Type *
Academic Title *
Please click here for eligibility criteria
Location *
Registrar
Are you aquiring a title as a registrar?
Discipline *
Specialty *
Subspecialty/Area of Interest 1 *
Subspecialty/Area of Interest 2
Subspecialty/Area of Interest 3
Salutation *
Given Name *
Surname *
Preferred Name
Date of Birth
Please enter the date in D/M/YYYY format
Gender *
E-mail address *
Redirect my UQ e-mail to this address
Please note, if correspondence is subject to confidentiality agreements we cannot forward it. You will be contacted for further details if you indicate you want mail forwarded.
Researcher ID
If you have not yet created a Researcher ID please do so at www.researcherid.com and populate your profile with your publications using Web of Knowledge
Home Address *
Home Suburb
Home State *
Home Postcode *
Work Address *
Work Suburb
Work State *
Work Postcode
Telephone (Home)
Telephone (Mobile)
Telephone (Work) *
Fax
Primary Employer *
Current Appointment *
UQ Contact Person
Contributions to Research at UQ *
e.g. published two papers, received an NHMRC Grant
Contributions to Teaching at UQ *
e.g. taught into all Paediatric Rotations at the Royal Brisbane Clinical School in 2009
Other Engagement at UQ *
e.g. participated in the School of Medicine Research Council and was a member of the School’s Alumni Steering Committee.
UQ MBBS Graduate
Please upload your Resume *

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