Registration: Shiftboard Employee Demo for Traci Spatz

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APPLICANT INFORMATION
 

License Information
* Professional License
 Yes  No
* Professional License State
* Professional License Expiration
* ACLS?
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* ACLS License Expiration
Specialty Nurse
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Other License?
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Specify/Notes

Eductaion
* School Name
* School Degree or Level
* School Graduation/Certificate Year
School Location
School Name
School Degree or Level
School Graduation/Certificate Year
School Location

Emergency Contact Information
Emergency Contact Name
Emergency Contact Phone
Emergency Contact Relationship

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