SHPA Residency Program – Advanced Training Resident Registration

SHPA Training Programs – Registrar Candidate Registration

Congratulations on being part of the SHPA Registrar Training Program

All Registrar candidates must be SHPA members for the duration of their Program. If you are not an SHPA member, please join first.

Pharmacists accepted into the Registrar Training Program via an accredited site are required to register with SHPA. This is in addition to internal HR processes at your hospital.

If you require assistance completing your registration or have any questions regarding the Registrar Training Program, please contact residency@shpa.org.au

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Your details

Preferred title:(Required)

First Name:(Required)

Last name:(Required)

Date of birth:(Required)

Gender:(Required)

Woman

Man

Non-binary

Other

Daytime phone number:(Required)

Mobile number:(Required)

Email address:(Required)

Home address(Required)

State and post code only

State / Province / Region ZIP / Postal Code

Are you an SHPA member?:

All candidates undertaking the SHPA Resident or Registrar Training Program must be SHPA members for the duration of the program. If you are not a member, please join – https://www.shpa.org.au/joinrenew

Yes

If you answered 'yes', enter your SHPA member number:(Required)

Workplace details

Workplace employer:(Required)

Name of residency site

Please indicate at which hospital you work?

What is your Reg-TP pathway?:(Required)

Registrar Training Program Mentor name:(Required)

Registrar Training Program leader name:(Required)

Staff member responsible for Registrar Training program

Director of Pharmacy/Chief Pharmacist :(Required)

Date you started as a Registrar candidate:(Required)

Briefly describe the personal and career goals you wish to achieve during your program:

Registration information

Date you became a fully registered pharmacist:

Your AHPRA registration number:

Can be sourced from the AHPRA website: http://www.ahpra.gov.au/Registration/Registers-of-Practitioners.aspx

How many years have you practiced in a hospital setting?:(Required)

Years

Education

University where you completed your primary pharmacy degree :

Highest tertiary qualification:

Select all that apply:

I have completed a Resident Training Program

I have obtained Advancing Practice credentials

Experience

Provide a brief summary of your previous experience:

e.g. an outline of the patient care areas where you have worked previously, any experience in research and education (teaching of students, interns, other staff), leadership and management.

Name

This field is for validation purposes and should be left unchanged.