Candidate Information Page (Experienced)

Candidate Name (Ms/Mr/Mrs) *

Only alphabets and apostrophes (') are allowed (Max 50 chars).

Upload Latest Photo *

File must be JPG, JPEG, or PNG and under 1MB.

Phone Number *

Must be a valid 10-digit number starting with 6, 7, 8, or 9.

E-mail ID *

Please enter a valid email containing '@' and '.'.

Gender

Date of Birth *

Candidate must be between 18 and 50 years old.

Present Address Permanent address is the same as present address

Permanent Address

Willing to relocate within or out of state?

Yes No

Select Qualification *

Please select a qualification.

Institution / College Name

Only alphabets, spaces, and apostrophes (') allowed (Max 100 chars).

Passing Year

Passing year must be at least 18 years after the date of birth.

State Council Registration Status

State Council Registration No. *

Use capital letters, numbers, and '/' only (Max 100 characters).

National Council Registration No.

Only digits are allowed (Max 100 digits).

Upload Council Registration Certificate

Only PDF files under 1MB are allowed.

Upload CV *

A CV is required. Only PDF files under 1MB are allowed.

3. Clinical Nursing Experience

Total Years of Experience *

Please select total experience.

Clinical Speciality

Only alphabets and spaces allowed (Max 100 chars).

Departments Worked In (Check all that apply):

ICU / Critical Care Operation Theatre (OT) Emergency / Casualty Daycare Pediatrics / NICU Cardiology General Ward

Hospitals Worked In (Names, Tenures & Roles) *

Only letters, numbers, spaces, and ', -, () allowed.

Any Other Certification / Course

Only letters, spaces, and ', () allowed. Numbers are not permitted.

4. Professional Reference

Reference Person Name & Designation

Only letters, spaces, and commas (,) allowed (Max 100 chars).

Reference Mobile Number

Must be a valid 10-digit number starting with 6, 7, 8, or 9.

Reference Email ID

Please enter a valid email containing '@' and '.' (Max 50 chars).

5. Candidate Declaration & Consent

I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief. I also understand that any false or misleading information can result in the rejection of my application. I hereby consent to Workvend : Healthcare storing and processing my credentials for the purpose of matching and evaluating me for healthcare placement opportunities.

You must accept the declaration before submitting.

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Candidate Information Page (Experienced)

1. Personal Information

2 Academic Qualifications & Licensure

3. Clinical Nursing Experience

4. Professional Reference

5. Candidate Declaration & Consent