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BSN Employment Data
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
State of residence (optional)
Your answer
Birthdate (month and day)
*
Your answer
Are you currently employed?
*
Yes
Not currently employed, and not seeking employment at this time
Not currently employed, but actively seeking employment
If employed, name of employer (optional)
Your answer
If employed, are you working in a position that requires an RN license? (optional)
Yes
No
Not currently employed
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Any additional information that you would like to share (optional)
Your answer
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