Job Interest Form If you’re interested in joining our team, fill out the form below and we’ll be in touch. Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Date of birth * MM DD YYYY Last 4 of SS # * Cell phone # * Home phone # * Hours you're looking for: * Full time Part time Either FT or PT Shift preference * Check all that apply First Second Third Position of Interest * Check all that apply RN LPN CNA IHA Counties of Interest * Check all that apply Alexander Avery Burke Cabarrus Caldwell Catawba Gaston Iredell Lincoln Mecklenburg McDowell Watauga How did you hear about us? Thank you!