Kennedy Application

If you are a registered nurse currently residing in the US on a temporary visa, we may be able to obtain a green card for you, without you having to leave the country. Please complete the form below so that we may know more about your situation. Be sure to provide us with an email and a phone number where we can reach you. We will respond to your query as soon as we receive your application. Thank you, in advance for your interest in Kennedy!

Please fill out the information below. Fields in red are required. Some of these fields may not be applicable to you, depending upon your education, experience, and work preferences. Thank you for your application!

BASIC INFORMATION
Last Name  
First Name  
Middle Initial  
Email  
Phone
(Please provide a land line)
 
Cell Phone  
Best time to call  
Street  
City/Town/Village  
State  
Zip  
Country  
Sex  
Birthdate (Month/Day/Year):  
Country of Birth  
Marital Status  
Number of Children  

US VISA
Type of visa:  
Date of Entry:  
Date of Expiration:  


YOUR EDUCATION
Nursing School Attended:  
Nursing School City/State/Country:  
Year Graduated:  
Number of years attended:  
Degree Obtained:  
Number of Years Experience Post Degree:  
List any additional degrees:  
Do you have any certifications, specializations, or supervisory experience? Please describe.  

YOUR EXPERIENCE
Please list your employment history, starting with your most recent.
Employer  
City:  
Country  
Dates   / until /
Position  
Duties Performed  


YOUR CREDENTIALS
Have you taken any of these exams?
CGFNS  
NCLEX  
IELTS  
TOEFL  
TSE  
TWE  
Have you applied for a VisaScreen?   Yes No

YOUR PREFERENCES
Please let us know if you have any specific requirements for where you want to work in the US, and the resons for your preference.
I prefer the following location:  
Reason:  

HOW DID YOU FIND US?
How did you hear about us?  
Additional Details