Employment Application

Join our team at High Quality Care

Employment Application Forms

HQNC Employee Application Forms

You have the option to fill the application form online by continuing below, or download and fill out the application form manually.

Continue to Online Application Form Download Application Form

Supporting Documents

The following documents provide additional information and forms you may need during the application process:

Employee Application Check List

Complete checklist of all required documentation

Employment Verification

Form for verifying past employment

LPN Job Description

Detailed responsibilities for Licensed Practical Nurses

RN Job Description

Detailed responsibilities for Registered Nurses

Interview Evaluation Form

Form used during interview process

Character Reference Form

Form for character references to complete

Hepatitis B Form

Healthcare vaccination documentation

Flu Vaccine Form

Flu vaccination documentation

Begin Online Application

Online Application Form

Complete the form below to apply. Fields marked with an asterisk (*) are required. Your progress will be automatically saved as you type.

Personal Information

Step 1 of 7

Tip: Fields marked with an asterisk (*) are required. You can save your progress and return later.

First Name *

Last Name *

Middle Initial

Application Date

Today's date is auto-filled

Date of Birth *

Street Address *

City *

State *

Zip Code *

Social Security # *

Securely stored and encrypted

Phone *

Email *

Emergency Contact Information

Name *

Relationship

Phone # *

I am a United States Citizen

Check this box if you are a U.S. citizen. If not, please fill out the work eligibility section below.

I am legally eligible to work in the U.S.

If not a U.S. Citizen, check this box if you have proper authorization to work in the United States.

Position Applying For *

Preferred Shift

Other position (if not listed above)

Work Preference

Date Available to Work *

Desired Salary

Have you been convicted of a felony?

A conviction will not necessarily disqualify you from employment.

Have you applied to our agency before?

Are you currently employed?