New Grad RN Interview Questionnaire
At this time we are only scheduling interviews for candidates that have either passed their NCLEX or have a scheduled NCLEX date.
Personal Information:
Full Name
*
First Name
Middle Name
Last Name
Current Location
*
Street Address
Street Address Line 2
City
State
Postal / Zip Code
Cell Number
*
E-mail
*
example@example.com
Questions and Details:
Nursing School Graduation/Expected Graduation Date
*
-
Month
-
Day
Year
NCLEX Status
*
Please Select
Passed
Scheduled
Not yet Scheduled
If NCLEX is scheduled, enter your NCLEX exam date
RN Licensed State
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Skip if not Licensed
OPT Approved Start Date
-
Month
-
Day
Year
Skip if no approved OPT Date
OPT Expected Start Date
-
Month
-
Day
Year
Enter Date you requested or plan to request.
Do you have your EAD Work Permit?
*
Please Select
Yes
No, still waiting to be issued
Do you have a Social Security Card
*
Please Select
Yes
No
What US State(s) will you accept a nursing assignment?
*
California
Minnesota
All of the above
None of the above
What is your immigration status?
*
Is there anything else you would like us to know about you?
Please Upload your current resume
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please verify that you are human
*
Submit
Should be Empty: