Application

ConTemporary Nursing Solutions, Inc.

Name*
First Last
Professional License*
State of License
Clinical Specialty with 2 years experience in last 4 (example, ICU, ER, MS, etc.)*
Please upload your Resume
Email*
Phone*
Address*
Street Address Address Line 2 City 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*