Please fill out the  form below for entry into the raffle.  A winner will be drawn at the end of each month.  All fields must be completed in order to participate.

 
name: email address (must be valid):
address:
city: state: zip:
phone: cell/pager:

 
specialty: RN      LPN     CNA     HHA     other: (please specify)
how did you hear about the position?

 
please click on this button after you have filled out the form   

Game Rules:  Only one submission per person per month is allowed.  The winner will be drawn at random the last day of the month.  The winner will be contacted via a US postage paid letter, over the phone, or by email at PHCS' discretion.  Participants must be US citizens residing within the continental 48 states to play.  Must be at least 18 years of age to play.  PHCS has the right to discontinue or terminate the online raffle at anytime without notice.

For more information please feel free to contact us at 414-541-5500 or toll free at 1-800-236-6623.

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