Application

for joint staff

Day Mnth Year

OFFICE USE ONLY Faculty of Health Sciences
Date of capture
Start Date Responsible for letter of motivation for appointment
End Date and renewals
PROF D VAN DER MERWE

Complete details below please

Honorary/Visiting/Joint: Position: Department & School

Joint Lecturer (Medical Physics) Medical Physics, Radiation Sciences, Clinical Medicine

Surname Ntombela
First Names Lethukuthula nqobizitha
Home Language Zulu
ID or Passport Number 8 1 1 0 0 3 5 4 7 7 0 8 1
Health Professional Council
Registration No
(where applicable) P H 0 0 0 2 1 1 9
Statistical information Race Gender Citizenship/Nationality
BLACK MALE SOUTH AFFRICAN
Nationality if not South African
Address: Residential 97 CASSANDRA AVENUE, BEDWORTHPARK, VANDERBIJLPARK, 1911
Address: Postal SAME AS ABOBE
Cell Phone No
inclusive of area code 0 7 8 3 2 4 3 7 7 0
e-Mail address lethunto81@gmail.com
Alternative e-mail address lnntombela@webmail.co.za
Skype Address(Where available)
Wits Staff No (if applicable)
Highest Qualification HONS IN MEDICAL PHYSICS
Institution UNIVERSITY OF LIMPOPO (MEDUNSA)
Year of Award of Qualification 2008
Field of research expertise:
Medical Physics

Teaching Experience
Undergraduate Y Number of years 33 3
Postgraduate Number of years
Supervision Experience
Masters N Number of students Willingness to supervise
Doctoral N Number of students Willingness to supervise

Other Academic Duties e.g. Position

N/A
on University Committees etc.

Registration for higher degree

within this faculty? Provide details if MSc PHYSICS
applicable
Wits Student No (if applicable) 8 1 8 4 1 1

HONORARY STAFF ONLY TO COMPLETE COMMITMENT FIELDS Please note that consideration for fee reduction or remission for own or
dependent studies depends on the following: tutorials/lectures / supervision amounting to 100 hours per year. Please indicate below
how much time you willing to commit to teaching (i.e. lectures or supervision) (See Policy attached to appointment letter): Only use
the NA category is your collaboration is primarily in research

Your commitment for tutorials/ lectures 48 Hours per annum: hrs

Your commitment for supervision 96 Hours per annum: hrs per student per annum

Applicant Signature
Date of Application
Signature of Department
Name
Decision Date
Signature of Department
Name
Decision Date
Signature of Department
Name
Decision Date