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Employment Application Form

Total Nurses Network
www.totalnursesnetwork-milwaukee.com
Nurses@tn-networks.com
844-489-8500

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Personal Information

Last Name:*      * denotes required field
First Name:*
Middle Initial:
Maiden Name:
Nickname:
Address 1:*
Address 2:
City:*
State:*

Note: Click button, enter 1st letter of state or scroll to your state code, then point and click to select.

Zip Code:*
Province:
Country: Best times to call
Home Phone:*
Work Phone:
Other Phone:
Fax:
E-mail:*
How did you hear about us?
If Other, please explain:

Personal Information Comments:

Note: Enter additional Personal Information comments in area to the left.


Work Preferences

Note: To select one option in each of the work preference boxes below, scroll, point and click on the option you wish to select.

Category(s) - Select the category(s) that indicate your employee classification(s).  

Note: To select multiple categories, scroll, depress and hold the control key (Ctrl), point and click on each category you wish to select.

 
 
Work Type(s) - Select the type(s) of employment you prefer.  

Note: To select multiple work types, scroll, depress and hold the control key (Ctrl), point and click on each work type you wish to select.

 
Service Area(s) - Select your preference of service areas, locations, or units within the facility.  

Note: To select multiple service areas, scroll, depress and hold the control key (Ctrl), point and click on each service area you wish to select.

 
Skill(s) - Select the skill(s) you possess and the tasks you can perform.  

Note: To select multiple skills, scroll, depress and hold the control key (Ctrl), point and click on each skill you wish to select.

 
State(s) - Select the state(s) in which you have license or wish to work.  

Note: To select multiple states, scroll, depress and hold the control key (Ctrl), point and click on each state you wish to select.

 
Work Preference Comments:

Note: Enter additional Work Preference comments in area to the left.


Education

Date: Click to select date.

Note:  Click button to select date. If unknown, enter closest estimate.

Degree:
School:
City:
State: Zip Code:

To Work History
Date: Click to select date.

Note:  Click button to select date. If unknown, enter closest estimate.

Degree:
School:
City:
State: Zip Code:

To Work History
Date: Click to select date.

Note:  Click button to select date. If unknown, enter closest estimate.

Degree:
School:
City:
State: Zip Code:

To Work History
Date: Click to select date.

Note:  Click button to select date. If unknown, enter closest estimate.

Degree:
School:
City:
State: Zip Code:
Education Comments:

Note: Enter additional Education comments in area to the left.


Work History

Current Company:
City:
State:
Start Date: Click to select date.

Note:  Click button to select date. If unknown, enter closest estimate.

Stop Date: Click to select date.
Position:
Key Responsibilities:
Reason for Leaving:

To Bottom
Previous Company:
City:
State:
Start Date: Click to select date.

Note:  Click button to select date. If unknown, enter closest estimate.

Stop Date: Click to select date.
Position:
Key Responsibilities:
Reason for Leaving:

To Bottom
Previous Company:
City:
State:
Start Date: Click to select date.

Note:  Click button to select date. If unknown, enter closest estimate.

Stop Date: Click to select date.
Position:
Key Responsibilities:
Reason for Leaving:

To Bottom
Previous Company:
City:
State:
Start Date: Click to select date.

Note:  Click button to select date. If unknown, enter closest estimate.

Stop Date: Click to select date.
Position:
Key Responsibilities:
Reason for Leaving:

To Bottom
Work History Comments:

Note: Enter additional Work History comments below.


Return to Total Nurses Network home page. Click to submit your entry.

Thank you for applying at
Total Nurses Network

Note: If you would like to print this page, please do so before you click the submit button at the bottom of the page.


Click to print screen.

Total Nurses Network | 10425 W. North Ave. Suite 331 Milwaukee, WI 53226

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