To apply for any open position, either submit this form, call the office or email.
Please provide the following contact information:
Social Security Number :
ID Number
Enter your license / certificate number in the space provided below.
Choose one of the following options:
Days / Evenings
Evenings/ Nights
Are you lawfully prevented from becoming employed in this country due to immigration or Visa status?
Have you been convicted of a crime within the last 10 years or been denied employment in a nursing position because of a criminal record? If yes, please explain.
Please either forward a resume or provide names & details for previous employment.
By entering your name below you agree to the following : I certify that the answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application as may be necessary to arrive at an employment decision. I hereby release the company and any former employer and any third party from any liability whatsoever that may be imposed as a result of the release of such information. Should I be employed by the Company any false or misleading information will result in my employment being immediately terminated. I hereby understand and acknowledge that any employment relationship with this Company is of an " At-Will " nature, which means that the employee may resign at any time and the employer may discharge employee at any time, with or without notice, with or without cause. It is further understood that this " At-Will " employment relationship may not be changed by any written document or by verbal agreement unless such change is specifically acknowledged in writing by an authorized Executive of this company. I also understand that Alternative Staffing Resources, Inc. retains the right to amend, modify, add or delete any or all policies or procedures at it's sole and absolute discretion. NOTE: I further understand that the preferred shifts listed on the first page may or may not be available due to the scheduling needs of the company's clients.