A Special Hiring Event
Thursday, April 16 • 5:30 - 7:30 pm at Vino on Main & Bells Gallery
Who are you registering to attend this event?
*
Experienced Nurse/ New Graduate (Not employed by Southeast Health)
Southeast Health Employee bringing a nurse as a guest
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Please fill out the information below to register for this event.
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Current Status
*
Please Select
RN
LPN
Nursing Student
Area of Interest
*
Were you referred by a current Southeast Health employee?
*
No
Yes
If yes, please provide name
*
Are you a former Southeast Health employee?
*
No
Yes
Southeast Health Employee Name
*
First Name
Last Name
Employee Number
*
Employee Department
*
Name of guest you are recruiting
*
First Name
Last Name
Guest's Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Guest's Current Status
*
Please Select
RN
LPN
Nursing Student
Submit
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