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Contact Information

Licenses


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Certifications

Check all applicable certifications and enter expiration date:

Education

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Employment

To submit your application, please agree to the terms and click SUBMIT below.

Personal Information Edit

First Name:
 
Last Name:
 
Middle Name:
 
Email address:
 
Mobile phone:
 
Discipline:
 
Specialty:
 
Secondary Specialty:
 
How did you hear about us?:
 
Please provide specifics:
 
Street Address:
 
City:
 
State/Province:
 
ZIP/Postal Code:
 
Country:
 
Home Phone:
 
Emergency Contact Phone:
 

Licenses Edit

License type:
 
State/Province:
 
Uploaded license:

Certificates Edit

Certification:
 
Expiration Date:
 
Uploaded certificate:
License or certification investigated:
 
If yes, details:
 

Education Edit

Professional education / College name:
 
Graduation date:
 
Degree:
 
Major:
 
State/Province:
 

Employment Edit

Facility / Employer name:
 
City:
 
State / Province:
 
Current Employer:
 
From:
 
To:
 
Discipline:
 
Specialty / Setting:
 
Unit / Floor / Dept:
 
If other, please specify:
 
May we contact your employer?:
 
Supervisor's name:
 
Supervisor's title:
 
Supervisor's phone:
 
Travel assignment:
 
Legal to work in the U.S.:
 
If no, details:
 
Type of work visa:
 

By submitting this application, I agree and consent to the terms and conditions stated herein, including, but not limited to those relating to the use and disclosure of information I have provided and methods by which AMN may contact me.

Thanks for Completing Your Application
Congratulations on completing your NurseChoice nursing application. You're now one-step closer to a rewarding career as a travel nurse. An NurseChoice career specialist will review your application and contact you with any questions and to discuss next steps in the hiring process.
In the meantime, check out the following resources:
Search Travel Nursing Jobs
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Thanks for choosing NurseChoice. We look forward to helping you make your travel nursing dreams come true.
Sincerely,
The NurseChoice Team
Thanks! We already have your application on file.
Our records show that you've already applied with NurseChoice, so there's no need to re-submit your application.
If you are interested in a specific job, please contact your recruiter directly at 1-866-557-6050.
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