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Are you over 18?*
Yes
No

Certified Nursing Assistant (CNA)?*
Yes
No

Do you have a Drvier's License?*
Yes
No

Do you have your CPR First Aid Certification?*
Yes
No

What license do you currently hold?
HHA RN LPN None

What shifts would you prefer?
Mornings Afternoons Nights

Do you have your TB skin test up to date?
Yes
No

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