2024 Orientation Form RN LiuFull Name 全名(Required) First Name 名字 Last Name 姓 Aide Code 護理員號碼Address 地址 Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Initial 縮寫(Required)Signature 簽名(Required)HiddenAdministrative StuffHiddenRN Evaluator First Last HiddenRN InitialHiddenLIC. NumberHiddenAide PositionHiddenHEP B Vaccination Yes, I accept vaccination No, I decline vaccinationPhoneThis field is for validation purposes and should be left unchanged.
