Registered Nurse (RN) – Lifestyle Center | Full-Time Application
Apply for a full-time RN position at our Lifestyle Center. Please complete all sections to ensure your application is considered.
Quick Eligibility Gate
Please answer these questions to determine your eligibility.
Do you currently hold a valid Registered Nurse (RN) license?
*
Yes
No
How many years of RN experience do you have?
*
Please Select
Less than 1 year
1-2 years
3-5 years
6-10 years
More than 10 years
Are you able to commit to a full-time position (minimum 36 hours/week)?
*
Yes
No
Contact Details
Please provide your contact information.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Town/City of Residence
*
Licensing & Credentials
Tell us about your nursing license and qualifications.
Licensing Body
*
Please Select
State Board of Nursing
Nursing and Midwifery Council
Other
License/Registration Number
*
License Expiry Date
*
-
Month
-
Day
Year
Date
Upload Proof of License (PDF, JPG, PNG)
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Highest Nursing Qualification
*
Please Select
Diploma in Nursing
Associate Degree in Nursing (ADN)
Bachelor of Science in Nursing (BSN)
Master of Science in Nursing (MSN)
Other
Upload CV/Resume
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Experience Snapshot
Share your nursing experience.
Areas of Experience (select all that apply)
*
Senior Care
Acute Care
Community Health
Palliative Care
Rehabilitation
Other
Have you supervised other nursing staff?
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Yes
No
Briefly describe your most relevant senior-care experience
*
Availability & Employment Status
Tell us about your current employment and availability.
Are you currently employed as a nurse?
*
Yes
No
If employed, are you willing to resign if selected for this role?
*
Yes
No
Not applicable (not currently employed)
Earliest possible start date
*
-
Month
-
Day
Year
Date
Preferred shift(s)
*
Day
Evening
Night
Flexible/Any
Clinical Confidence
Rate your confidence in the following clinical skills (1 = Not Confident, 5 = Very Confident).
Please rate your confidence in the following clinical areas:
*
Rows
1
2
3
4
5
Medication Administration
Wound Care
Patient Assessment
Care Planning
Infection Control
IV Therapy
Compliance & References
Compliance questions and reference details.
Have you ever been subject to disciplinary action by a licensing or regulatory body?
*
Yes
No
Do you consent to a background check as part of the application process?
*
Yes, I consent
No, I do not consent
Reference 1 – Full Name
*
Reference 1 – Relationship to You
*
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
*
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
Final Fit Question
Help us understand your motivation.
Why are you interested in joining the CHH Lifestyle Center?
*
Declaration & Signature
Please confirm and sign below to complete your application.
I confirm that the information provided is accurate and complete to the best of my knowledge.
*
I confirm the above statement.
Signature (please sign below)
*
Submit Application
Submit Application
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