***Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.***
1.
Do you possess a current LPN license from the Maryland Board of Nursing or one of the states in the Multi-State Licensure Compact Current Membership?
Yes
No
2.
Please provide your license number and expiration date in the box below.
3.
Describe your experience as a Licensed Practical Nurse.
Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application. If you do not possess experience in this area, put N/A in the box below.
4.
Please select the facilities where you are interested in working (you may select multiple locations). When completing your application, please be sure to select the counties associated with the facilities for which you have an interest in order to be considered:
Clifton T. Perkins Hospital Center, Jessup MD (Howard County)
Eastern Shore Hospital Center, Cambridge MD (Dorchester County)
Department of Budget and Management