IVMD Nurse Job Application

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New Hire Applicant Details
Date / Time
Position: Registerd Nurse / Licensened Pratical Nurse / CSR
Note: All Applications will be treated confidintially and will never be disclosed or used for any purpuse other than shortlisting for the current job openning.
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Please Fill the following needed information accurately
Full Name*
Address*

Country

City - State or emirate (If in UAE)

Emirate State / Province

Postal / Zip CodeCountry
Email*
Mobile No.*
Age*
Gender*
Nationality *
(Choose one) License details*

I'm Licensed by the state of Louisiana to work as a Registered NurseI'm Licensed by the states of Louisiana to work as a Licensed Practical NurseI'm Licensed by the state of Louisiana to work as a ParamedicMy License is under processI'm not licensed to work as either Nurse or ParamedicOther
License date of issuance

DayMonthYear
License date of Expiration

DayMonthYear
Medical license

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Total years of experience as a Nurse?*
Total years of experience as a Paramedic?*
Notice Period *

No need for any NoticeOne monthTwo MonthsOther
Current or most recent Salary*
Minimum expected salary*
Is the salary negotiable? *

YesNoSlightly negotiable
Highest Educational Certifecate
Major
State of issuance
Visa Status*

EmploymentVisit VisaTourist visaFamily sponsorshipSpouse sponsorshipCitizenOther
Marital Status

MarriedSingleOther
No. of Children

Languages*