Apply Today

Thank you for taking the time to complete our online employment application. Please fill out the application below as completely as possible. After completing your application, allow 30-45 minutes for processing and call our office so we can be sure we have all of your correct information.

*All applicants are asked to call in weekly to provide their availability.

personal information:

 

First Name (Required)
Middle Name
Last Name (Required)
Nickname / Preferred Name
Street Address / Apartment
(Required)
 
City (Required)
State/ zip Code (Required)  
Home Phone (Required) - Area code and phone number
Cell Phone - Area code and phone number
Emergency Contact (Required) - Area code and phone number
Date of Birth (Required)
Email Address (Required)
Position applying for
What Kudzu location are you applying for? (Required)

general information:

 

Placement
What is your Lifting Capacity?
Are you willing to working in a non smoking environment?
Driver's License Number
Issuing State
Are you willing to take a drug test today?
Any History of Criminal Convictions?
Details of Criminal Convictions
What position is your primary specialty?
What is your sub-specialty?
What position are you applying for?
 
availability:

 

Check Days Available
What shift do you prefer?
Either 7a-3p, 3p-11p, 11p-7a,
7a-7p, or 7p-7a.
You may list more than one
Date are you available to start? Month: Day: Year:
How many hours are you willing to work in a week?
Are you willing to work overtime?
Yes No
What is the minimum pay you desire?
Hourly rate or annual salary
How many miles are you willing to travel to a position?
Please list the machines you are most familiar with.
Please list the computer charting system you are most familiar with
Please list any Medical Licenses or Certifications you have. Please include the License or Certification Number and expiration date.
   
education:

 

High School
Name of Institution
Street Address
City  
State / ZIP Code  
Start Date (Month / Year) Month: Year:
End Date (Month / Year) Month: Year:
Did you graduate?
 
College or Technical school
Name of Institution
Street Address
City  
State / ZIP Code  
Start Date (Month / Year)
End Date (Month / Year)
Did you graduate?

Recent Employment (List most recent first )

 

past Employer #1
Company Name
Street Address
City
State / ZIP Code  
Supervisor Name
Phone Number - Area code and phone number
Job Title  
Reason for Leaving  
Start Date (Month / Year)   Month: Year:
End Date (Month / Year) Month: Year:
Start Wage Hourly rate or annual salary
End Wage Hourly rate or annual salary
May we contact this employer for a reference check?
Yes No

past Employer #2  
Company Name
Street Address
City
State / ZIP Code  
Supervisor Name
Job Title  
Reason for Leaving  
Start Date (Month / Year)  
End Date (Month / Year)
Start Wage Hourly rate or annual salary
End Wage Hourly rate or annual salary
May we contact this employer for a reference check?
Yes No

past Employer #3
Company Name
Street Address
City
State / ZIP Code  
Supervisor Name
Job Title  
Reason for Leaving  
Start Date (Month / Year)  
End Date (Month / Year)
Start Wage Hourly rate or annual salary
End Wage Hourly rate or annual salary
May we contact this employer for a reference check?
Yes No
 
Skills (check as many as apply)
Medical:
ICU: Intensive Care Unit OR: Operating Room CCU: Cardiac Care Unit
PACU: Post Anesthesia Care Unit CVICU: Cardiovascular ICU Geriatrics
NICU: Neurological ICU Psychiatry NICU: Neonatal ICU
Detox/Substance Abuse Care PICU: Pediatric ICU Medical Rehab
Respiratory Telemetry Oncology
Renal Burn L & D: Labor & Delivery
Mom/Baby Ob/GYN ENT
Public Health Pediatrics Nursery
Orthopedics Cosmetic/Reconstructive Pre-Op.
Home Health Hospice  
     
Emergency Medicine:
Emergency Deparment Pediatric Emergency Dept.
Flight Nurse: Helicopter/ Fixed Wing Sane: Sexual Assualt Nurse Examiner
Trauma center:
Trauma Center Trauma - Major
Trauma - Minor Trauma - Transport

 

Computer Software:
Microsoft Excel Microsoft Word Microsoft Outlook
Quickbooks    
clerical / Administrative:
Medical Coding & billing Medical Records data Entry
Insurance Scheduling Medical Receptionist
     

I certify that my answers are true and complete to the best of my knowledge. i understand that nothing in this application is a contract or offer of employment. I will be an at-will employee as it relates to 41-1-11-110 of the SC Code. Kudzu Staffing. Inc, or I may terminate employment at any time for any reason. No Kudzu Staffing, Inc. representatives can verbally or written by policy or practice change my at-will employment.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Please take a moment to review your application.  Indicate that you have read the above statement by entering your initials in the box below.  To complete this application, click on the Submit Application button.

Initials:  (Required)   

This Company is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with this Company depends solely on your qualifications.