You are applying for: Medical / Surgical

Nurse Registration Form

Essential Criteria for Nurse Registration - You must be a registered GENERAL nurse
- Have at least 2 YEAR of clinical experience
- Have English to the equivalent of IELTS 7.0 overall
- Be ready to commit to the process & passing the required exams

Only one registration form needs to be completed per candidate
Fields marked by * are required

Personal Details First Name *
Last Name *
Country
Address
Postcode
Email *
Home Phone No
Mobile Phone No

Nursing Job requirement In which location do you want to work?
Briefly describe your typical day at work

Nursing Background Country/ies where you have full nursing registration
Country/ies where you have trained in nursing:
Licenses Held (eg RGN, RMN, RSCN, Midwife etc)
NCLEX Status *
CGFNS Status *
US Immigration Status
Speciality *
Years of Experience
Other Information
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