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Candidate Registration Form

Welcome to Central Park RPN. Please complete the form below to help us match you with roles that fit your licensure, availability, and professional goals. Upload all applicable documents to ensure we can move quickly on opportunities that match your background.

Contact Details

* First Name

* Last Name

* Email

Mobile

Street

City

State

Zip Code

Country

Date of Birth

Work Preferences

License Type

License Number

State(s) Licensed In

Are you currently working?

Are you open to travel assignments?

Are you open to school nurse roles?

Preferred Weekly Hours

Work Preferences

If you've selected "Other", please specify

Documents

Resume

Choose file

Nursing License

Choose file

CPR/BLS Certification

Choose file

Government-issued ID

Choose file

NIHSS or CCRN Certification (if applicable)

Choose file

Miscellaneous Upload (for additional certifications or documents)

Choose file