Welcome! Please complete the following APPLICATION and a representative will contact you upon reviewing this application to discuss next steps if we are interested in pursuing you for hire. Please note that there is a place in this form where you can UPLOAD YOUR RESUME & COVER LETTER or feel free to email those documents to info@lifepointcares.com after completing the application below. Thank you for your interest in working with Life Point!

Position you are applying for

Qualified Professional

Office Manager

Clinical Director

Registered Nurse

Applicant Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Birth

YYYY

Current Age

EDUCATION

High school name & city

College name & city

Degree Earned

Post graduate college name & city

Degree Earned

Any other special certifications or industry-related recognitions

EXPERIENCE

Last Employer Name

Your job description at that job

Length of time at that position

Supervisor's name and phone number

Reason for leaving

Previous Employer Name

Length of time at that position

Supervisor's name and phone number

Reason for leaving

Other Employer Name

Your job description at that job

Length of time at that position

Your job description at that job

Supervisor's name and phone number

Reason for leaving

REFERENCES

Personal Reference

Please provide their name, phone number a how you know them.

Professional Reference

Please provide their name, phone number a how you know them.

Why are you interested in working in this role?

How did you hear about this position?

UPLOAD DOCUMENTS