APPLICATION FOR INITIAL REGISTRATION ASSESSMENT FOR

INTERNATIONALLY EDUCATED NURSES (IEN) WHO HAVE NEVER BEEN

REGISTERED IN CANADA

Part V – Verification of Graduation from School of Nursing

Section A Applicant to complete section A and forward to your school of nursing for completion of Section B. Your
school is to mail it directly to the College of Registered Nurses of Nova Scotia (the College) at the address noted
below.

Name
Surname Birth/Former Name(s) Given Names

School of Nursing Year graduated

_______________________________________________________________________________________________________
Section B To be completed by the Director, School of Nursing, and mailed directly to the College of Registered
Nurses of Nova Scotia along with a copy of the applicant’s nursing transcript.
Kindly provide the requested information regarding the nursing program completed by the above named
applicant. If the program was taken in a country where English is not the official language, please secure
translations through the nursing association in your country, or a qualified translator.

THIS CERTIFIES THAT

Surname Birth/Former Name(s) Given Names (underline name used when enrolled in school)

born on was admitted to

Month/day/year Name of School of Nursing

in The program commenced and was completed

City/Province/State/Country Month/year Month/year

and the applicant was awarded a(n):

____ associate degree ____diploma ____baccalaureate. The program led to qualification as a general registered
nurse on the general register:
Yes No If no, please explain

The language of instruction for theory and clinical was___________ The length of the course was _______ months
and included theory and clinical courses at the general nursing level.

CRITICAL INFORMATION:
The table below MUST be completed, identifying the number of theory and clinical hours in the five (5) program areas.
The application cannot be processed without this information. A “good faith” estimate will be accepted. The applicant’s
official transcript must accompany this form, identifying the theory and clinical hours.

Program Areas Total Theory Hours Total Clinical Hours

Medical / Surgical Nursing
(including specialty areas)
Obstetrical Nursing
Pediatric Nursing
Psychiatric Nursing

At the time the above noted program was taken, the School was approved officially by

Signature Name
(Please Print)

Position Date

Seal is to be imprinted on the transcript and on this application.

SEAL

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College of Registered Nurses of Nova Scotia – Registration Services
Suite 4005, 7071 Bayers Rd, Halifax NS, Canada B3L 2C2
Phone 902-491-9744, ext 225 Toll Free in Nova Scotia 1-800-565-9744 Fax 902-491-9510
E-mail address: registration@crnns.ca Website: www.crnns.ca
02/10