ࡱ> DFC bjbj 2*xikxik 84M,3$yy:#######%(###yyyj#y#yy:!,R" v$1^! #$03$"R?)?)R"?)R"p>,y$##%T3$?) :  Format for CVs of Individuals Participating in the Research Studies in South Africa Study: __________________________________________________________ Protocol: __________________________________________________________ Designation: __________________________________________________________ {e.g. National Principal Investigator, Investigator (Principal / Sub/Co)} Curriculum Vitae Personal details: Name: ___________________________ Work Address: ___________________________ ___________________________ ___________________________ Contact information: Telephone no.: ____________________________ Fax no.: ____________________________ Cell no.: ____________________________ E-mail address: ____________________________ Academic and Professional Qualifications: ________________________________________ ________________________________________ ________________________________________ Health Professionals Council of South Africa (HPCSA) registration number: {If applicable (or other health professions body registration particulars e.g.. Nursing Council} ________________________________________ Current Personal Medical Malpractice Insurance Details: (Medical and Dental Practitioners) ___________________________________________________ Relevant related work experience (brief) and current position: ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ Participation in clinical trials research in the last three years (title, protocol number, designation) {If multiple trials, only list those with relevance to this application, or in the last year}: ____________________________________________________ ____________________________________________________ Peer reviewed publications in the past 3 years. ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ Date of last GCP training (as a participant or presenter). Please supply Name of Course. (dd/mmm/yyyy) - and Name of GCP course and/or presented by (Company/Person) ____________________________________________________ Please note: Kindly attach a copy of certificate of GCP Course attended. Training at Investigators Meeting and/or Start up Meeting do not imply having attended a GCP Course. Ref: SOP.HREC.010 Any additional relevant information supporting abilities to participate in conducting this study {briefly} ____________________________________________________ Signature: ____________________________ Date: _____________________     2025 TEMPLATE OF CV 91Ƭ HREC (Medical) CV Template  FILENAME \p R:\ETHICS REGULATORY DEPARTMENT.2025\APPLICATIONS AND SUBMISSION FORMS 2025\050.CV example for Investigators and Sub-Investigators.doc Page  PAGE 1 of  NUMPAGES 2 !6GWX^* W n q r t u  * + , A B Q m n o y Žܱhn#h,5CJ\aJhn#h,>*CJaJhn#h,CJaJhn#h,5CJaJhlpOJQJh,OJQJhFB}h0 h,5\h, hFB}5\hFB}56>*h>'56>*h,56>*7WX* t u + , A B  & F$a$B n o   C D m n 0 G H q r s h^h ^` & F   C D m n 0 G H q r s   B C x y ^PQR#$YZݵݦhn#h,56CJ]aJhn#h,>*CJ\aJhn#h,5>*CJaJhn#h,CJ\aJhn#h,5CJaJhn#h,>*CJaJhn#h,CJaJ>   B C x y ^PQR#^ & Fh^h#$YZ67hih^h $^a$gdj & F^67BCX^hi±£||j\\Q\Q\\Fhn#h,CJaJhFB}5CJ\aJhn#h,5CJ\aJ#hn#hj6B*CJ]aJph#hqa56B*CJ\]aJph)hn#hj56B*CJ\]aJphhn#h,6CJ]aJ hn#h,56CJ\]aJ# *hn#h,56CJ\]aJhn#h,>*CJaJhn#h,6>*CJ]aJ *hn#h,6>*CJ]aJ()ĸЬ{hR+h3oh2Q6B* CJ]aJmH phsH %h2Q6B* CJ]aJmH phsH %h>'6B* CJ]aJmH phsH h2Q6CJ]mH sH h2Qhn#h2QB*CJphh>'5B*CJphhFB}5B*CJphhNa~5B*CJphh2Q5B*CJphhuMjhuMUhn#h,CJaJhn#h,>*CJaJ)*$a$gd3ogdpC$a$gd3o$a$gdn# )*+89\]Ƴ}nƳ\Ƴ\NJFhMh2QhpCh2Q6CJ]aJ#h]6CJ]aJmHnHsH uh2Q6CJ]aJmH sH #hb6CJ]aJmHnHsH u#hFB}6CJ]aJmHnHsH u#hH6CJ]aJmHnHsH u%jh2Q6CJU]aJmH sH "h3oh2Q6CJ]aJmH sH +jh3oh2Q6CJU]aJmH sH "hpCh2Q6CJ]aJmH sH hn#h,CJaJ0&P 1. 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Aptos Display3. AptosA$BCambria Math"qhGgGg|'D D !S20 3Q@P?M2!xx Y v  Format for CVs of Investigators:Mary-Ann RichardsonEdzani Nephalela  Oh+'0  8D d p | $Format for CVs of Investigators:Mary-Ann RichardsonNormalEdzani Nephalela2Microsoft Office Word@@Sj@^$@^$D  ՜.+,0 hp|  WHC  !Format for CVs of Investigators: Title  !"#$%&'()*+,-./012456789:<=>?@ABERoot Entry F w$GData 1TableS)WordDocument2*SummaryInformation(3DocumentSummaryInformation8;CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q