ClubStaffing

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Skills Checklists

Congratulations on your decision to apply for an allied position with ClubStaffing! Before we can offer you an allied employment opportunity, an electronic skills assessment must be completed. From the skills checklist below, please locate the list that matches your specialty and complete the online form. Be sure to review your information thoroughly before clicking the submit button. Thank you!

ClubStaffing
1905 Corporate Blvd NW
STE 200
Boca Raton, Florida 33431
Fax: (561) 367-0884

ER Technician Skills Checklist

Denotes required field


This profile is for use by healthcare professionals in this discipline and specialty. It will not be a determining factor for the program.
Please enter your full legal name as it appears on your Social Security Card.
First Name*	Middle Name	Last Name*

E-Mail Address*	Phone Number*

You must agree with the statements at the bottom of the form before submitting your skills checklist.
Please read and agree to the statements below by marking the checkbox.
* I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form. Falsification of any information provided, will result in being ineligible to travel with AMN. I hereby authorize the Company to release this Skills Checklist to the Client facilities in relation to consideration of employment as a Healthcare Professional with those facilities.

1. No experience; requires education, training and supervision	2. Intermittent experience; may need support or supervision
3. Proficient; consistent experience, independent	4. Expert level; can teach/supervise others