Placing People First!

Palm Beach County, Florida-Based L.L.C

Data & Privacy Affirmation

Date [mm/dd/yyyy] *

Recruiter's Name

Name on Registered Nursing License *

Best # to contact?

Resident state *

Best time to contact?

In the morning (AM)
in the afternoon (PM)
In the evening (PM)
Weekends?

Zip Code *

RN Unit Specializations, Disciplines and Would Consider? *

Currente Facility (if employed at the moment) *

Resident State *

Desired Pay

Housing Situation

Doesn't own or rent
Break Lease
Sell House

Which are the most important factors in your career?? *

Pay
Location
Work life Balance

Degree

Current Shifts

Days
Afternoon (swing-shift)
Nights
Weekends

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Placing People First!

Palm Beach County, Florida-Based L.L.C

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