newfrontierhhc.com Job Application: Registered Nurse

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Office 314-838-1006
Fax 314-549-8797
Email contact@newfrontierhhc.com

We proudly accept Private Pay, VA and Medicaid clients.

Business Hours
Monday - Friday 9:00 AM to 5:30 PM
We are available to assist you during weekends/holidays/emergencies.

We are here for you!

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Job Application: Registered Nurse

Title: Registered Nurse

Fields marked with an asterisk (*) must be filled out before submitting.

Personal Identification

First Name *

Middle Initial

Last Name *

Email Address

Mailing Address *

City *

State

Postal zip code *

Telephone *

Cellular phone *

Social Security Number *

Driver’s License # & State of issue *

Date of Birth *

Background Screening

Type of Employment Desired

Please specify Days and Hours of Availability. Indicate if you are willing to work overnight shifts.

Are you legally eligible for employment in this country? *

Has your driver’s license ever been suspended or revoked? *

Do you have any criminal convictions, findings of guilt, pleas of guilt, and/or pleas of nolo contendere except minor traffic violations? *

If yes, please disclose all criminal convictions, findings of guilt, pleas of guilt, and/or pleas of nolo contendere and explain in detail.

Are you listed on the Employee Disqualification List? *

If considered for hiring, will you consent to a pre-employment criminal record check? *

If considered for hiring, will you agree to provide car insurance confirmation? *

If considered for hiring, will you consent to a closed records check pursuant to Section 610.120 RSMo (if applicable)? *

List all aliases, including maiden names, and social security numbers you have ever used. *

Educational Background

List previous three (3) educational institutions attended, beginning with the most recent. *

What relevant designations, licenses or registrations, if any, do you possess? *

If other, please explain:


Do you have the following safety certifications? *

Employment Background

Upload your Resume

Upload certifications, licenses, reference/recommendation letters, etc.

Applicant Questionaire

I acknowledge that I am 18 years of age or older. *

I acknowledge that I can read, write and follow instructions. *

I have at least six (6) months paid work experience as: *

I acknowledge that I have my own source of transportation and have the minimum liability insurance as required by law. *

Privacy Policy

You need to read and agree to our privacy policy before we can accept your application. *	I certify that all the information I have provided is true, complete and correct. The information contained within this application or any cover letter or resume attached is not shared with any third parties. The information is used by the employer only as an aid in the hiring decision making process. The applicant, by signing the application gives the employer consent to collect the information contained herein and use for the purpose specified. I authorize this company to investigate all statements contained on this application. I understand that any misrepresentation or omission of facts called for is cause for immediate disqualification and/or if employed, immediate dismissal. I also authorize this company to make any investigation(s) of my personal, financial, and/or credit background (including, but not limited to) obtaining a credit report (also known as a “consumer report” under the Fair Credit Reporting Act/Consumer Reporting Act) for the purpose of evaluating my qualifications for employment. This authorization extends for twelve months from today’s date. I understand that if I am hired, I will be required to provide criminal background check AT MY COST ($11.00), proof of identity and legal authority to work in the United States, proof of certifications or educational qualifications, and a copy of a valid driver’s license and proof of insurance. Furthermore, I understand and agree that if employed, I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same rights to terminate my employment at any time, with or without prior notice, except as may be required by law. This application does not in any way constitute an agreement or contract for employment. I have read and understood the privacy policy.

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