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Basic Info

First Name: *
Last Name: *
Email: *
Mobile: *
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Nursing Education_Pick all that apply:
Nursing License Type-Pick all that apply:

Timeframe & Location

Preferred estimated start date?:
Possible Locations of Interest:

Address Information

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City: *
State: *
Country: *
Postal Code: *

Social Media

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Licensing & Documentation

NCLEX passed:
NCLEX Pass Date:
NCLEX Scheduled Date:
CRNE Passed:
CRNE Passed Date:
CGFNS VisaScreen Status: *
CGFNS VisaScreen expiry date:
CGFNS VisaScreen-Date application submitted:
Specialty Certification (By exam) Please list:
Provincial RN licenses ever held: *
USA RN licenses ever held: *


Citizenship required to determine type of work permit needed for USA.  Country of birth determines ability and time-frame to obtain Green Card Sponsorship.  Canadian citizens do not require a Green Card to work in the USA.  RNs from other countries and currently working in Canada as an RN in an acute care hospital of at least 125 beds may qualify for Green Card sponsorship.  We encourage nurses originally from other countries to apply.  Must have current VisaScreen and have passed NCLEX.
Citizenship (Pick all that apply): *
Citizenship (if other):
Country of Birth: *
Do you have a USA SSN? (Social Security number):
Covered under spouse work visa? Which?:

RN Nursing Education

Name of Nursing School: *
Degree Obtained: *
Name of 'Other' degree:
Nursing School Grad date-Month/Year: *
Nursing School Location-City, Province: *

Continuing Education & Certs

Current Certifications:
List other certifications:

Professional Details

Highest Qualification Held: *
Current Job Title: *
Current Employer (or enter New Grad, Not currently employed, mat leave, etc)):
Employer Address-City, Province, Country (or N/A):
RN Experience in Years- Post graduation as a licensed RN:
Skill Set:
Additional Info:

Other Info

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Attachment Information

Cover Letter:
Resume: *
RN License:
BLS, ACLS, NRP etc.: