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Nursing Experience

Are you a Christian Scientist? (required field)
We only accept Christian Scientists into these classes.
 Yes No

Are you a Christian Science Nurse? (required field)
 Yes No

If so, where do you currently work?

If not, do you have any nursing experience? Explain.

Personal Information

Do you speak English? (required field)
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Name (required field)

Address

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Email (required field)

Your Phone Number (required field)

Secondary Phone number (if available)

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