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Please fill out the information below (all fields are required).

  • Applicant MUST complete all the fields below before submitting their application for consideration. The applicant MUST be a manager or supervisor in any department of a skilled nursing facility (Nursing, Dietary, Social Services, Housekeeping, Activities) located in Long Island.
  • Applicant's Information

  • Applicant's Organization

  • REQUIRED: Applicant must submit a Letter of Interest and a Letter of Support from facility's Administrator or Executive Director.
  • Please upload your signed Letter of Interest describing your experience, educational level and how this program will assist in your professional development. Also, include a signed Letter of Support from your Administrator. Please combine both letters into a single PDF file. Only PDF files are accepted. Note: If you are having difficulty attaching a file, please FAX both letters to Melony Spock at 877-893-5744. MAX FILE SIZE: 10MB
    Accepted file types: pdf.

  • If you have any questions, please call Melony Spock at 518-462-4800, Ext. 21.