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Screening Application

(please send resume with applications)

* indicates required

Name: *

Licensure/Certification Type:

Address: *
City: State: Zip:

Phone Number: *

Email Address:

How did you hear about us?

Experience
Current Employer: Job Title:
 
Date of Employment: From: To:
Name of Previous Employer: Job Title:
 
Date of Employment: From: To:
Name of Previous Employer: Job Title:
 
Date of Employment: From: To:
Any Specialty Experience (i.e. Pediatrics, Hospice, etc.)

Position Applying for: *
RN
LPN
HHA
PT/OT
Other [ ]

Availability
Full Time
Part Time
Per Diem
Evenings, weekends, holidays, on-call, shift rotations

Please verify you have the following:
Proof of U.S. Citizenship *
Valid NY State Drivers License *
Available Car *

 

 

 


Directions to the VNA of Albany from the NYS Thruway:

  • Take exit #24 to I-90 east, exit #2, Washington Avenue.
  • Turn LEFT at light onto Washington Avenue going east, go about 1-1/2 miles, passing UAlbany and the NYS Office Campus on your right. 
  • Turn LEFT at the light by the KeyBank and Exxon-Mobil station onto Colvin Avenue. 
  • The VNA is located at 35 Colvin, at the right corner of Lincoln.

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