Nursing Incentive Program Signup
Please fill out this form to enroll in the incentive program and review your details.
Full Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Employee ID
*
LPN or RN?
*
Please Select
LPN
RN
Case Interest & Scheduling
SECTION 1 — Per-Shift Pay Bumps (added on top of base hourly rate)
Which premium shifts are you available to work?
Morning
Day
Late Afternoon (+$1/hour)
Overnight (+$2/hour)
Weekend (+$3/hour)
Premium amounts are added to your base rate. Stacking rules (whether multiple bumps combine) are being finalized.
SECTION 2 — 8-Week Commitment Program
Do you want to enroll in the 8-week commitment program (requires working 24+ hours per week for 8 weeks)?
Yes
No
A $500 bonus is paid at the end of the 8-week commitment (requires working 24+ hours per week for 8 weeks).
Short Shifts
A short shift is any shift between 4 and 7 hours.
Are you available to work short shifts?
Yes
No
MVP Cases
MVP cases pay an additional $2 per hour.
Are you available to take MVP cases?
Yes
No
Comments or Questions (optional)
Is there a specific patient case you're already interested in?
Enter the patient or case name if you have one in mind (optional).
Which setting(s) are you interested in working?
School
Patient's Home
Which scheduler would you like to schedule a discussion with about the incentives?
Please Select
Jessica
Christy
Marie
Kurt
Flora
Bev
Alfrien (Weekend scheduler)
Carissa (Weekend scheduler)
Submit
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