Please fill out the form to continue with your application.

General Information

First Name *

Last Name *

Email *

Phone *

Date of birth *

Country of Birth *

Educational Attainment

Educational Degree Completed *

Country where you attended your Education *

Name of College or University *

Graduation Date *

Work Experience

Are you currently working with a Recruitment Agency? *

Yes

No

Are you a nurse practicing in a foreign country? *

Yes

No

Are you currently employed as a nurse? *

Yes

No

Do you have a pending green card sponsorship? *

Yes

No

Have you taken NCLEX? *

Yes

No

What was the result?

Passed

Failed

Pending

In what state?

In what country are you currently residing? *

How long have you been currently employed as a nurse? *

What is your specialty? *

Referral Source

How did you hear about RIGHT ACCORD? *

Captcha