Application ConTemporary Nursing Solutions, Inc. Name* First Last Professional License*RNLPNNPState of License Clinical Specialty with 2 years experience in last 4 (example, ICU, ER, MS, etc.)* Are you looking for Per Diem daily work or a Contract? Do you have a particular hospital? Or a specific shift? Do you have any prefrence for a start date? Please upload your ResumeMax. file size: 75 MB.Email* Phone*Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Social Security # Date of Birth ~I am able to perform all essential functions of the position for which I am applying. ~I have never been convicted of a felony. ~ My clinical license has never been suspended ~I understand that any misrepresentation, falsification or material omission in this application will result in my failure to receive an offer for employment or my immediate dismissal. ~I authorize ConTemporary to contact prior employers. I release all parties and persons from liability that may result from furnishing information. ~I agree that if I am hired, my employment with CTS can be terminated at will, with or without cause, with or without notice at any time.* I Agree Electronic Signature - please type your complete name below:* Date* MM slash DD slash YYYY Untitled Δ