Triad Medical Academy Application-Instructor

PERSONAL INFORMATION
* Country
* State/Province
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*It is required by the NC Department of Health & Human Services that an Instructor have at least 2 years of experience as a Registered Nurse.
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EMPLOYMENT ELIGIBILITY
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EDUCATION
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LICENSE OR CERTIFICATION (RN, LPN, Etc.)
LICENSE OR CERTIFICATION (RN, LPN, Etc.)
CERTIFICATION (CPR, BLS, Etc.)
PREVIOUS EMPLOYMENT
PROFESSIONAL REFERENCE
TEACHING EXPERIENCE
DISCLAIMER
I, the Applicant, certify that my answers are true and honest to the best of my knowledge. If this application leads to my eventual employment, I understand that any false or misleading information in my application, or interview, may result in my employment being terminated.

I authorize any person, organization, or company listed on this application to furnish you any and all information concerning my previous employment, education, and qualifications for employment. I also authorize you to request and and receive such information.  
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Triad Medical Academy, LLC
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Triad Medical Academy, LLC

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