Job Application - 24HourNurse Staffing

Personal Information

First Name*

Last Name

Email*

Phone*

Street Address*

City*

State*

Zip*

Job Interest & Experience

Position Interested In*

Specialty*

CNA
LPN / LVN
RN

Do you have a clear background?*

Yes
No

Have you worked as a nurse for AT LEAST 2 years?*

Yes
No

Will you have transportation or have access to transportation to and from your assignment?*

Yes
No

What shifts are you available to work?*

Select All
12 hour – Days
12 hour – Nights
8 hour – Days (1st Shift)
8 hour – Evenings (2nd Shift)
8 hour – Nights (3rd Shift)

What is the earliest date you can start work?*

Reference 1

Supervisors Name*

Your reference MUST be a supervisor, manager, or charge nurse – or they CANNOT be used.

Phone Number*

Facility Name & Location (City, State)*

Please include the facility you worked with this reference. This MUST reflect your resume.

Dates you worked with this reference?*

Example: January 2020 – June 2020 MUST reflect your resume.

Reference 2

Supervisors Name*

Your reference MUST be a supervisor, manager, or charge nurse – or they CANNOT be used.

Phone Number*

Facility Name & Location (City, State)*

Please include the facility you worked with this reference. This MUST reflect your resume.

Dates you worked with this reference?*

Example: January 2020 – June 2020 MUST reflect your resume.

Resume & BLS

Does your Resume list your FULL address?*

Yes
No

Example: 123 Street, Nowhereville, TX, 12345

Does your Resume list where you received your education?*

Yes
No

Your Resume MUST list the institution’s full name and location (city, state), and the month/year of graduation.

Does your Resume have gaps in your employment?*

Yes
No

Your Resume MUST have NO gaps in employment to be considered for a position.

Does your Resume list the facility names, city and state, as well as the dates you worked there?*

Yes
No

Your Resume MUST have the full facility name, city and state it is located in, and the dates you worked there. (Example:Fellowship Health and Rehab, – Dallas, TX / June 2020 – July 2020)

Upload your Resume*

Accepted file types: jpg, png, gif, pdf, Max. file size: 33 MB.

Upload a copy of your BLS Card*

Accepted file types: jpg, png, gif, pdf, Max. file size: 33 MB.

Are you currently working with a recruiter*

Recruiters Name*

Message

How did you hear about 24 Hour Nurse Staffing?*

24 Hour Nurse Website
Indeed
Facebook
Google Search
Received Text Ad
Received Email Ad
Recruiter
Referred from a friend/co-worker

Would you like to sign up for our mailing list and receive the latest job updates to your email and phone?*

Yes
No