Your email address will be used as your login name allowing you to return to our website to update your profile. If you are a returning applicant, please sign in or reset your password using the Login button.
Information which you provided on your initial application will be populated in the following fields. Please review these fields to verify accuracy, and provide the additional requested information. Thank you!
Use your resume to fill in many of the fields on this application form.
This information is used to Verify employment history, credentials, and other items related to our thorough background check. Your information will be kept confidential and is not used for any credit or financial background checks.
Highest education level completed?
Has your professional license or certification, in any state, ever been under investigation, been suspended or had disciplinary action taken against it?
Have you ever been named as a defendant in a professional liability action?
Have you ever been convicted of a crime other than a minor traffic violation?
Are you either a US Citizen or can you submit verification of your right to work in the US?
If you currently hold any of the following certifications, please provide the expiration date. If other, please provide the certification name and expiration date.
Upload any additional attachments. Note: You can attach a total of up to 10MB of data. Your resume and all attachments combined must be less than 10MB.
Please provide your work history for the last 7 years. It is our policy to verify and reference the employment history of each candidate.
Please explain any gaps in employment. If no gaps please specify N/A in the field box below.
Please provide at least two Clinical Supervisors or Managers that you have worked with. The references must be: MD, PA, NP, RN or LPN.
If applying for a clinical position, you must provide (2) Clinical professional references. These need to be references who have supervised your work. The Reference Title must be Nurse or Physician (RN / LPN / MD / PA / NP).
Where did you work with this reference?
To submit your application, please complete these steps. Fields marked with a red asterisk (*) are required.
I attest that I am the applicant and the information provided in this application is complete and accurate, to the best of my knowledge. Providing incomplete or inaccurate information may result in disqualification from the program, and may be a violation of state law(s) that could result in civil penalties. Nurses and More is authorized to obtain information from my current and previous employers, and to release information in support of my application (application, references, background search results, etc.) to Nurses and More’s client institutions. Nurses and More may also share information regarding my employment with its affiliates and appropriate governmental or licensing entities; and send me employment opportunity-related information at fax numbers or email addresses that I provide. I understand that Nurses and More, certain states and/or Client institutions may require criminal background checks, and I consent to such checks. Prior to conducting any background checks that qualify as consumer or investigative consumer reports, I will be provided, and will return, separate disclosure and acknowledgement forms as required by Nurses and More. I agree, in consideration of your employing me, that I will not seek or accept employment, either directly or indirectly in any capacity from any clients of Nurses and More’s to whom I have been assigned, until I have sought and obtained written approval from branch management. I also agree that I will not solicit these clients on my behalf, nor on the behalf of any future employer(s).
I certify that all of the information in this application is true and correct as of this date.
