Licensure Documents

Doc 1 and 2: Initial Application for License as a Nursing Assistant (Revised 06.20.19)
Doc 8 and 9: Renewal Application for CNA (Revised 06.20.19)
Doc 10 and 11: Request for permit as a Graduate Nurse (Revised 06.20.19)
Doc 12 and 13: Application for license as a Certified Technician (Revised 06.20.19)
Doc 14 and 15: Renewal application for license as a Certified Technician (Revised 06.20.19)
Doc 16 and 17: Application for Endorsement of license as a RN and LPN (Revised 06.20.19)
Doc 18: Application for license by waiver, for renewal and reinstatement – RN, LPN (Revised 06.20.19)
Doc 19: Continuing Education Form – RN, LPN (Revised 06.20.19)
Doc 20 and 21: Requirements for licensure by examination NCLEX (Revised 06.20.19)
Doc 22 and 23: Application for Licensure by Examination – NCLEX (Revised 09.03.2020)
Doc 24 and 25: Application for Endorsement – APRN (Revised 06.20.19)
Doc 26 and 27: Renewal Application for – APRN (Revised 06.20.19)
Doc 28: Verification of Employment (Revised 06.20.19)
Doc 29: Verification of license (Revised 06.20.19)
Doc 31: Request for Name, Address and Email Change (Revised 06.20.19)
Doc 32: Applicant checklist for Graduate Nurse Permit (Revised 06.20.19)
Doc 33: Applicant checklist for Certified Nursing Assistant (Revised 06.20.19)
Doc 34: Applicant checklist for Certified Technician (Revised 06.20.19)
Doc 35: Applicant Checklist for RN and LPN Endorsement (revised 06.20.19)
Doc 36: Applicant Checklist as APRN – initial (Revised 06.20.19)
Doc 37: Renewal Checklist for CNA (Revised 06.20.19)
Doc 38: Renewal Checklist for Certified Technicians (Revised 06.20.19)
Doc 39: Renewal Checklist for LPN and VN (Revised 06.20.19)
Doc 40: Renewal Checklist for RN (Revised 06.20.19)
Doc 41: Renewal Checklist for APRN (Revised 06.20.19)
Doc 42: Reinstatement Checklist for CNA (Revised 06.20.19)
Doc 43: Reinstatement checklist for Certified Technicians (Revised 06.20.19)
Doc 44: Reinstatement checklist for Licensed Practical Vocational Nurses (Revised 06.20.19)
Doc 45: Reinstatement checklist for Registered Nurses (Revised 06.20.19)
Doc 46: Reinstatement checklist for APRNs (Revised 06.20.19)
Doc 47: Certification of Related Learning Experience (Revised 06.20.19)
Doc 49: Application for NCLEX Score Transfer (Revised 06.20.19)
Doc 50: Requirement for NCLEX Score Transfer (Revised 06.20.19)
Doc 51 and 52: Application for Initial License as Advance Practice Registered Nurse (Revised 06.20.19)