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Nursing Job Application Form Template

Easily gather essential details for nursing applicants

Finding the right nursing candidate is crucial, and a structured application process can make a world of difference. This Nursing Job Application Form Template is designed for hospitals, clinics, and healthcare organizations to streamline the hiring process, ensuring you gather all necessary information from applicants. With clear sections for personal details, qualifications, work history, and references, you can improve your recruitment efficiency, enhance candidate experience, and maintain compliance with hiring standards. Explore the live template to simplify your application process today.

Full legal name
Email
Phone number
Current location (city, state/province)
Are you legally authorized to work in the country of the job?
Yes
No
Will you now or in the future require employer visa sponsorship?
Yes
No
Position applying for
Registered Nurse (RN)
Licensed Practical/Vocational Nurse (LPN/LVN)
Certified Nursing Assistant (CNA)
Nurse Practitioner (NP)
Clinical Nurse Specialist (CNS)
Other
Please Specify:
Preferred employment type
Full-time
Part-time
Per diem
Contract
Temporary
Earliest start date
Preferred care settings
Please Specify:
Primary nursing license type
Registered Nurse (RN)
Licensed Practical/Vocational Nurse (LPN/LVN)
Certified Nursing Assistant (CNA)
Nurse Practitioner (NP)
Clinical Nurse Specialist (CNS)
Other
Please Specify:
License number
Licensing state/province
License expiration date
Current certifications
Total years of nursing experience
Under 1 year
1-2 years
3-5 years
6-10 years
11+ years
Primary specialties or units
Please Specify:
EHR/EMR systems used
Epic
Cerner
Meditech
Allscripts
Athenahealth
None
Other
Please Specify:
Comfort with IV insertion and phlebotomy
Yes
No
Not applicable
School or training institution
Graduation or program completion date
Highest completed education in nursing
High school diploma/GED
Nursing diploma
Associate degree in nursing (ADN)
Bachelor of science in nursing (BSN)
Master of science in nursing (MSN)
Doctorate (DNP/PhD)
Other
Please Specify:
Most recent employer
Job title
Employment dates (e.g., Jun 2022 - Present)
Key responsibilities and accomplishments
I consent to a background check if required
Yes
No
If yes, please provide details
Any active or pending license disciplinary actions
Yes
No
Prefer not to say
Reference full name
Reference relationship
Reference phone
Gender identity
Woman
Man
Non-binary
Prefer to self-describe
Prefer not to say
How did you hear about this opportunity?
Company website
Job board
Social media
Employee referral
Recruiter/Agency
Career fair
School program
Other
Please Specify:
Type your full legal name as signature
Date
I certify that the information provided is accurate and complete to the best of my knowledge
Yes
No
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Paper art illustration depicting a nursing job application form for an article on FormCreatorAI

When to use this form

Use this form when you need to hire nurses fast and fairly across units like med-surg, ICU, ER, or long-term care. It helps HR and nurse managers collect the essentials in one place: licensure, certifications, shift availability, and recent experience. Use it for hospital intakes, home health onboarding, staffing agency placements, or school nurse openings. If you want to prequalify prospects before a full application, start with the Pre-application form. For general roles beyond nursing, you can route candidates to the New job application form or a broader Job seekers application form. The outcome: cleaner data, quicker screening, and a shortlist you can move to interviews with confidence.

Must Ask Nursing Job Application Questions

  1. What active nursing licenses do you hold, including state, license number, and expiration date?

    This verifies eligibility and supports license checks before interviews. It helps you avoid lapses and confirm the candidate can practice where you hire.

  2. Which clinical specialties and units have you worked in, and for how long?

    This maps skills to patient acuity and unit needs. You can match candidates to ICU, ER, med-surg, or long-term care with confidence.

  3. Which certifications do you currently hold (BLS, ACLS, PALS, TNCC, etc.)?

    Certifications show readiness for the role and compliance requirements. Current life-support credentials reduce onboarding delays.

  4. What shifts and schedule are you available for, and when can you start?

    This aligns staffing gaps with candidate availability. Clear timing and flexibility cut back-and-forth and speed scheduling.

  5. Have you ever faced disciplinary action or malpractice claims? If yes, please explain.

    This surfaces potential risk and supports compliance. Transparent context lets your team assess suitability and any need for further review.

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