Job Application Form
Focal Point Medical Staffing
Please select position your Applying for?
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LPN Goldsboro, NC (12 Week Contract: 7a-7p or 7p-7a $38hr)
LPN Jacksonville, NC (6-week Contract: 7p-7a $38hr)
Full Name
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First Name
Last Name
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
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example@example.com
Phone Number
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What position are you applying for?
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Please Select
LPN
RN
Available start date:
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Month
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Day
Year
Date
We only staff for 4+ Week Contract Assignments. We DO NOT staff Per Diem.
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of
Negative TB test within 12mnths or Chest X-Ray
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Current CPR
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Covid Vaccination (Preferred not Required)
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Healthcare License Registry (CNA, Med Tech, LPN, RN)
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Last 4 digits of SS#
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Drivers License or Passport
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Contact US!
919-578-9101 Staffing@focalpointstaff.com
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