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?
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Yes
No
Are you currently employed as a nurse?
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Yes
No
Do you have a pending green card sponsorship?
*
Yes
No
Have you taken NCLEX?
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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?
*
Agent
Word of Mouth
Alumni Referral
Associations
Recruitment Event
RIGHT ACCORD Website
Client Referral
Google
Facebook
Forum
Friend
Job Board
LinkedIn
Twitter
Other
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