Telephone Numbers(632) 6338114

(632) 6339117

Fax Number(632) 6318020

E-mail Addressinfo@sentosarecruitment.com

Recruitment Agency

PERSONAL PROFILE

*First Name:

*Last Name

Other Name(s):

Nickname

*Address:

*City/Province:

*Zip Code:

*Country:

*Tel: Home Work Country Code Area Code

*Mobile:

Please contact me through my: Home Work Mobile Any

*Birthday:

*Gender: Male Female

*Title:: Mr. Mrs. Miss Other

Fields marked with an asterisk (*) are required.

Fill out the form below and fax it to (632) 631 8020. We’ll get in touch with you to discuss your application. Alternatively, you may fill out the online form at www.sentosarecruitment.com

APPLICATION FORM

CURRENT EMPLOYER

Company Name:

Job Title/Position:

Employer’s Address:

Date Employed: From To

Telephone Numbers(632) 6338114

(632) 6339117

Fax Number(632) 6318020

E-mail Addressinfo@sentosarecruitment.com

Recruitment AgencyPREVIOUS EMPLOYER

Company Name:

Employer’s Profile

Job Title/Position:

Employer’s Address:

City/Province:

Zip Code:

Country:

Date Employed: From To

QUALIFICATIONS

Nursing School:

Province:

Date Graduated:

School’s Mailing

Address:

City/Province:

Zip Code:

Country:

Local Code:

Skills Summary:

Telephone Numbers(632) 6338114

(632) 6339117

Fax Number(632) 6318020

E-mail Addressinfo@sentosarecruitment.com

Recruitment Agency NURSING EXPERIENCE

State the number of months for the following.

Number of Years/Months

*Medical

Surgical

*Operating Room:

*Critical Care:

*Other (Describe)

Have you completed the Visa Screen? Yes No

Date issued: If not, when do you plan to apply:

Do you have a CGFNS Certificate? Yes No

If so, date issued:

If not, when do you plan to apply?

Have you passed the NCLEX? Yes No

If so, date passed:

If not, when do you plan to take the exam?

Have you worked outside the Philippines? Yes No

If so, where: Dates: From To

Do you have any relatives in the U.S.? Yes No

Relationship:

If yes, where: City State

Do you have any health problems? Yes No

If yes, please describe:

Do you have any physical limitations? Yes No

If yes, please describe:

Telephone Numbers(632) 6338114

(632) 6339117

Fax Number(632) 6318020

E-mail Addressinfo@sentosarecruitment.com

Recruitment Agency DOCUMENT CHECKLIST

Let Sentosa Recruitment Agency assist you in completing your

requirements. Simply tick the appropriate box of those requirements that

you already have.

Resume

Transcript of Records

Nursing Diploma

Board Certificate

Employment Certificate

NCLEX / CGFNS Certificate or in the process of obtaining CGFNS

Certificate or RN License

TOEFL / TSE / IELTS Certificate for the processing of ICHP

Certification

Visa Screen Certificate

PRC License

Certificate of Seminars / Trainings

2 copies of 2x2 pictures

Passport