Trip Tastic Nursing and Employment Agency: Employee Application Form

Trip Tastic Nursing and Employment Agency: Employee Application Form

Apply to join our compassionate and professional nursing team providing 24-hour in-home care across Barbados. Please complete all sections accurately.
Full Name (First, Middle, Last)*

First NameLast Name
Email Address*
example@example.com
Mobile Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Home Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Residential Address (Street, Parish, Postcode)*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Date of Birth (DD/MM/YYYY)*

MonthDayYear
Date
Nationality*
Are you legally eligible to work in Barbados?*
Nursing Council of Barbados Registration Number*
Nursing Qualification*
If Other, please specify your Nursing Qualification
Year of Graduation*
Name of Institution*
Total Years of Nursing Experience*
Geriatric CarePediatric CarePalliative Care / End-of-Life CarePost-Operative CareChronic Disease Management (e.g., diabetes, hypertension)Care for Individuals with DisabilitiesOther
If Other, please specify your Specialized Experience
Languages Spoken (besides English)
Type of Employment*
Preferred Shift*
Are you available to work weekends and public holidays?*
Do you have your own reliable transportation?*
Reference 1: Full Name*

First NameLast Name
Reference 1: Relationship to you (e.g., former supervisor, colleague)*
Reference 1: Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Reference 1: Email Address*
example@example.com
Reference 2: Full Name*

First NameLast Name
Reference 2: Relationship to you*
Reference 2: Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Reference 2: Email Address*
example@example.com
Upload Resume/CV

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Upload Nursing Council of Barbados Registration Certificate

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Upload Nursing Certificate

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Upload Professional Photo

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Upload Police Certificate of Character

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Upload First Aid Training Certificate

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Upload Health Certificate

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Upload Two Letters of Reference

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I agree to the terms and conditions
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