Job Fair Registration – Nursing Aide – Chinese General Hospital and Medical Center

Note: PLEASE USE CAPITAL LETTERS and PUT “N/A” in fields that are not applicable.

Date

Carreer Job Fair Registration*

Onsite

Virtual

Source*

Others

Employee's full name*

Referred by:

Position*

Area/Department*

Applicant's Name*

First Middle Last

Suffix

Present Address*

Street Address Barangay City Region

Permanent Address*

Age*

Birthdate*

Gender*

Female

Male

Mobile Number*

Landline No.

Email Address*

Enter Email Confirm Email

Upload your Resume, Diploma and TOR (Transcript of Records)*

Drop files here or

Accepted file types: pdf, docx, png, jpg, Max. file size: 20 MB, Max. files: 3.

Educational Background

Name of School*

Course/Degree Taken*

Years Attended (From-To)*

PRC License Details

For newly-registered nurses, please put "N/A" if PRC license is not yet available.

When did you pass your licensure exam?*

PRC License No.*

PRC Expiration Date

Upload one (1) of any of the following documents: 1) PRC license, 2) PRC Oath form, 3)PRC Renewal Appointment, or 4) Notice of admission and a screenshot of your name in the list of Nursing Board passers*

Drop files here or

Accepted file types: pdf, jpg, docx, png, Max. file size: 30 MB, Max. files: 3.

Note: If expired, please attach your PRC renewal appointment form.

Employment Details

Clinical/Hospital Work Experiences

1. Designation*

1. Years of Experience (From-To)*

1. Name of the Institution*

2. Designation

2. Years of Experience (From-To)

2. Name of the Institution

3. Designation

3. Years of Experience (From-To)

3. Name of the Institution

Signature*

I hereby certify that the information in this application form is true and correct and that I have not knowingly withheld any facts or circumstances that would if disclosed, affect my application. I understand that any misrepresentation or omission of facts on my part shall be sufficient cause for the rejection of my application or dismissal if employed. I authorize the Chinese General Hospital and Medical Center to confirm all the information contained herein and submit myself to a physical examination and other qualifying tests.