1. (a) The application described in OAC 310:2-15-3 is required for use pursuant to 63 O.S. § 1-1950.4 and shall be used for the purposes set forth in that statute.

2. (b) The uniform employment application for nurse aide staff requires the following:

   1. (1) personal information;
   2. (2) employment desired;
   3. (3) U.S. military record;
   4. (4) prior work history;
   5. (5) educational background;
   6. (6) certification;
   7. (7) references;
   8. (8) background information;
   9. (9) applicant's employment application certification and agreement;
   10. (10) previous certified nurse aide training;
   11. (11) applicant's signature certifying no previous conviction and authorizing criminal history record checks; and
   12. (12) Any additional information needed to answer all questions fully.

Added at 18 Ok Reg 646, eff 1-10-01 (emergency)

Added at 18 Ok Reg 2026, eff 6-11-01

Amended at 24 Ok Reg 1896, eff 6-25-07

Amended at 38 Ok Reg 1916, eff 9-11-21