Nurse Application

Camp Nock-A-Mixon is seeking a qualified and enthusiastic nurses to join our team for the upcoming summer season. As a camp nurse, you’ll play a vital role in providing healthcare and ensuring the well-being of our campers and staff in a fun and rewarding environment.

Apply Now – Nurse Application

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Birthdate(Required)

Gender

Male

Female

Social Security #

Education

Name of College

Current Year

References

Reference 1 Name

First Last

Relationship

Phone

Email

Reference 2 Name

First Last

Relationship

Phone

Email

Employment History

Employer 1

Position

Phone

Start Date

End Date

Employer 2

Position

Phone

Start Date

End Date

Background

Have you ever been convicted of a crime?(Required)

Yes

No

If yes, please provide details.

Do you give permission for a criminal record check?(Required)

Yes

No

Certifications

Please list any certifications earned.