First Name

Last Name

Your Email

Phone Number

Date Of Birth

Citizenship

Country Of Birth

Current Country of Residence

EDUCATION & WORK EXPERIENCE

Are you currently working (or have you been working within the past year) as a registered nurse?
YesNo

What is your current specialty?
Not ApplicableAcute Medical UnitACUTE SURGICAL ONCOLOGYAmbulatoryBlood BankBurns and PlasticsCardiologyCasualtyCath LabCertified Nursing Aide (CNA)Coronary Care Unit (CCU)CVICUDay SurgeryDialysisEndoscopyERER - PediaGeriatricHDUHealthcare Aide (HCA)HematologyHemodialysisHome CareHome HealthICUICU - Cardiac ICUICU - CVICUICU - MICUICU - Neuro ICUICU - NICUICU - PICUICU - SICUL & DLong-term Care (LTC)Med / SurgMedicalMedical & Surgical ICUMedical Technologist (MT / MedTech)Need ExperienceNeuro- RehabNeurologyNew GradNot ApplicableNurseryOB - GyneOccupational Therapist (OT)Onco / HemaOncologyOPDOROR - CVOROR - OphthalmologyOR-PACUOR/ Day SurgeryOrthopedicOtherPACUPaediatric Cardiac Medical & Surgical ICUPalliative CarePCUPediaPediatric ORPersonal Support Worker (PSW)Physical Therapist (PT)Post - PartumPrivate Duty NursePsych / Mental HealthRadiologyRehabSBCUSchool NurseStep Down UnitSurgicalTelemetryTrauma ICUUrgent Care

What is your current profession?
Not workingRegistered Nurse (RN)Licensed Practical Nurse (LPN)Registered Practical Nurse (RPN)Certified Nursing Assistant (CNA)Healthcare Aide (HCA)Medical Doctor (MD)Medical Technologist (MT / MedTech)Occupational Therapist (OT)Physical Therapist (PT)Other

Have you passed the NCLEX?
YesNo

Have you passed the English exam (IELTS/TOEFL)?
PassFailExpiredNoScheduledWaiting for resultsN/ATOEFL IBTRescorePending Re-take
Do you have a previously-filed employment-based Green Card (I-140) petition?

YesNo

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