Submit Resume

Thank you for your interest in RWJ Visiting Nurses. Fill-in and submit this form to

Today is

I would like to be contacted about job opportunities for

Nurses
Home Health Aides
Rehab Therapists
Social Workers
Nutritionists
Management
Clerical / Support

I heard about RWJVN from

Ad (publication name)

Employee (name)

Employment agency (name)

Web Search Engine (name)

Other (indicate)

My Contact Information

First name

Last name

Company

Address line 1

Address line 2

City

State  

ZIP

Email address

Confirm Email

Daytime phone


I prefer to be contacted via
 Email        Phone        US Mail


Employment Information

Date Avaliable

Position Desired

Salary Desired

Availability
 Full time  
 Part time  
 Per diem  
 Temporary days

Days Available
 Monday  
 Tuesday  
 Wednesday  
 Thursday  
 Friday  
 Saturday  
 Sunday

Hours Available
 
 I am willing to work overtime

Geographic Preference

 I am a previous applicant

I am age 18 or older

I can legally work in the US

I have been convicted of a crime (traffic violations are not crimes)
If so, describe  

 I am a licensed driver and have a car available for work

I can perform the tasks of the position for which I am applying
 With accomodation       Without accomodation

If with accommodation, how would you perform the tasks with that accommodation?


Professional Information

New Jersey State Licensure

Licensure

Effective date

License number

Expiration date

 

New Jersey State Certification

Registry of certification

Effective date

Registration number

Expiration date

 NJ registration is pending

 

Out-of-State Licenses

State(s)

License number(s)

Education and Training

High School or Equivalent

Name of School

Dates Attended

Degree & Date Earned

Field of Study

 

Business or Technical School

Name of School

Dates Attended

Degree & Date Earned

Field of Study

 

College

Name of School

Dates Attended

Degree & Date Earned

Field of Study

 

Other Training

Name of School

Dates Attended

Degree & Date Earned

Field of Study


Work Experience

Note: Start with most recent position; furnish dates and explanation for each period of unemployment of one month or more.

Present/Last Employer

Employed From  To   (mm/yyyy)

Address

Supervisor's Name

Supervisor's Phone

Job Title

Type of Work

Reason for leaving

 Check if we may contact employer


Previous Employer (2)

Employed From  To   (mm/yyyy)

Address

Supervisor's Name

Supervisor's Phone

Job Title

Type of Work

Reason for leaving

 Check if we may contact employer


Previous Employer (3)

Employed From  To   (mm/yyyy)

Address

Supervisor's Name

Supervisor's Phone

Job Title

Type of Work

Reason for leaving

 Check if we may contact employer


Additonal Qualifications

Special knowledge, technical, computer or individual skills

Publications, awards, etc.

Military service & duties

Resume

 Attached is a copy of my resume file (file will only be sent if box is checked)


Or mail a paper copy of your resume to

Robert Wood Johnson Visiting Nurses
746 Livingston Avenue
North Brunswick, NJ 08902

Attn. Human Resources

Applicant References

During your interview for employment you will be asked to supply the VNA of Central Jersey with three professional references: “people to whom inquiries as to character or ability can be made” on your behalf. These individuals should be people that you have worked with during prior employment.

REFERENCE #1

Name

Job Title

Company Name

Phone (work)

Phone (home)

Relationship:   Supervisor    Co-worker

REFERENCE #2

Name

Job Title

Company Name

Phone (work)

Phone (home)

Relationship:   Supervisor    Co-worker

REFERENCE #3

Name

Job Title

Company Name

Phone (work)

Phone (home)

Relationship:   Supervisor    Co-worker


Applicant Statement

 I agree with the RWJVN Terms & Conditions. I have answered all questions to the best of my ability. If employed, I realize false information will be grounds for dismissal. I authorize any necessary inquiries as to my character, reputation, and ability and release those supplying any information from all liability. I understand that upon an offer of employment, I will be required to pass a physical examination prior to employment.


All qualified applicants receive consideration for employment without regard to race, color, religion, sex, age, national origin, handicap, disability, sexual orientation or veteran status.