January 2018 Availability Submission Form

Please complete and submit your availability for shifts in January 2018 before 11:59pm on December 14th, 2017. Enter any specific requests for the Staffing Department into the Availability Notes section. You will receive confirmation by email. Early submissions sent prior to December 10th will qualify you for our Early Bird Drawing for a $25 Sheetz Gift Card.

Click here if you would prefer to complete and return a printable version.

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Name:  
Email:  
Phone:  
Notes:  

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Priority given to nurses that turn availability in on time and offer a "fair share" of weekend availability.