Florence Night and Day Please call 1-800-684-3570 for your no obligation consultation.
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Job Interest Form Make a difference in someone's life today!
Once you submit this form to us, we hope to soon be in contact with you.

All applicants must complete the Uniform Employment Application for Nurse Aide Staff (Adobe pdf format) and return it to us via fax, mail, or in person at one of our office locations. Applicants must print out the above pdf file and complete it by hand, it cannot be completed online.

We have employment opportunities throughout Oklahoma, including Oklahoma City, Edmond, Tulsa, Stillwater, and Lawton.

(Download Adobe Acrobat PDF Reader)

We are serious about security

Florence Night and Day protects the security of the information you enter here by using Secure Sockets Layer (SSL) software.

Our SSL certificate uses high-grade encryption to secure all information sent to us via this form.

High-grade encryption makes it very difficult for anyone to view the information you submit to us.

We are very serious about protecting your privacy and ensuring the confidentiality of any information you share with us.

This is one more way you can distinguish our company from many others. The difference really is Night and Day.
Fields marked with an * are required,
however the more information you can provide us,
the quicker we can move forward!
 
Your Name and Contact Information
 * Your Name  
  (First Name)   (Middle Initial) (Last Name)
       
 Your Maiden Name
 * Primary Phone
  
 Alternate Phone
 Your E-mail
 Your Street Address
 City, State, & Zip Code

Your Certifications and Experience
Certified Nursing Aide
Certified Home Health Aide
Personal Care Assistant
 Your Caregiving Experience (in years)  

When You Can Work
Weekdays (Monday - Friday)
Weekends (Saturday and/or Sunday)
No More than 8 Hours per Day
From 8 to 12 Hours per Day
One or more 24 Hour (Live-in) shifts per Week

Your Questions or Comments

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