Nurse/Clerical Position Application

Have you ever applied to this company in the past?

Yes

No

Have you ever (Select all that apply):

Been suspected, charged, or convicted of an offense, misdemeanor/crime, or released from prison within the past 10 years.

Ever abused, neglected, sexually assaulted, exploited, or deprived a person?

Subjected any persons to serious injury as a result of intentional or grossly negligent misconduct?

None of the above

Please Select all that apply:

I am at least 18 years or older.

I have a valid drivers license, auto insurance, and personal transportation.

Possess all the required licenses and professional certifications to perform the job for which you are applying.

Thanks for submitting!

717 Cameron Dr, Blackshear, GA 31516, USA

52 N. Oak St, Baxley, GA 31513, USA