Global Staffing Strategies Application
To proceed, print this page and fill out the application. PLEASE FAX TO 314-361-6440 OR MAIL YOUR COMPLETED APPLICATION, COPY OF RESUME (IF AVAILABLE) AND PROOF OF CGFNS AND TOEFL RESULTS TO:
4949 West Pine, Suite 2B
St. Louis, Missouri 63108 U.S.A.
Feel free to ask questions via email at glblstrat@aol.com or via phone at 314-361-6344.
Please print all information.
APPLICANT INFORMATION
NAME: (FIRST, MIDDLE, LAST) ___________________________________________________
STREET ADDRESS:____________________________________________________________
CITY:______________________________________ STATE OR PROVINCE: _____________
COUNTRY: _______________
Additional Address Information: __________________________________________________
Phone Number: __________________________ Fax Number: ___________________________
E-mail Address: _________________________________________________________
EDUCATION
Name of College / University:_________________________________________________
Location: _____________________________________________________________
Month and Year of Graduation: ___________ Type of Degree Obtained: _____________________
Major: ____________________________________ Minor: __________________________
Grade Point Average at time of Graduation: __________
Licensing: Type of license _______________________ Expiration date __________________
CGFNS Examination: (date and document or certificate number) __________________________
TOEFL Examination: (date and document or certificate number) __________________________
WORK HISTORY
Current or Last Employer: _____________________________
Location: _____________________________________
Title/Position: ___________________________________
Areas of Nursing Experience: ______________________________________________________
PERSONAL INFORMATION
Have you ever been to the United States of America? (yes or no) _______
If yes, was it for business or travel? ________________________
Do you have any friends or family in the United States? (yes or no) _________________
If yes, complete information below:
NAME: ____________________________________
RELATIONSHIP: ______________________________________
STREET ADDRESS: ___________________________________
CITY: ____________________________ STATE: _______________ ZIP CODE: __________
PHONE NUMBER: _____________________________
4949 West Pine, Suite 2B, St. Louis, Missouri 63108
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