NOF | B.C. SOLUTIONS

Let's Start by Setting up Your Account

First name

Last name

Your Date of Birth?

Month

Day

Year

Your Email

Best Contact Number to Reach You?

Are you authorized to work in the U.S.?

Please upload your active nursing license.

Do you have an Active Nursing License ( RN, LPN, LVN, NP, CRNA, CNM,CNS)? If no, Please upload your most recent certification.

License Number?

Expiration Date

Month

Day

Year

State(s) Licensed/Certified In?

Have you ever had any license restrictions or disciplinary actions? (Yes/No, if yes please explain.)

Please List two professional references that are not related you.

Reference 1

Reference 2

Emergency Contact?

Any health conditions we should be aware of?

Are you willing to float?

Are you open to extensions? Permanent placement?

Top 5 cities or states you're interested in working in? (Separate with comas)

Please add a brief bio about your needs and expectations as a nurse.