Nursing Career Ladder Application
Please complete this form for consideration in Clark-Lindsey Nursing Career Ladder. For questions, please contact Darla Schall at
dschall@clark-lindsey.com
.
Name:
Your answer
Unit/Shift:
Your answer
What position are you applying for?
Mentor
Skills Trainer (must be a Mentor before applying for this role)
Orientation Preceptor (must be a Mentor before applying for this role)
Admissions Specialist (must be a Skills or Orientation Trainer before applying for this role)
Quality and Safety Specialist (must be a at the training level before applying for this role)
Comfort Specialist (must be a at the training level before applying for this role)
Dementia Specialist (must be a at the training level before applying for this role)
Team Lead (must be at the specialist level before applying for this role)
Clear selection
Briefly explain why you're interested in this role:
Your answer
Have you discussed this role with your supervisor?
Yes
No
Clear selection
Do you have any questions?
Your answer
Phone Number:
Your answer
Email:
Your answer
Preferred Contact Method:
Call
Email
Thank you!
The selection process takes place 4 weeks before the class begins. You will be alerted approximately 3 weeks prior to the start of the class whether or not you’ve been accepted into the program. For questions, please see Darla Schall or your DON.
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