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    Request For Personalised Application Form For Registration With An Bord Altranais

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    ico_is
    This document is a request form for a personalised registration application with An Bord Altranais (the Nursing Board of Ireland). It requests basic contact information such as name, date of birth, address, and nationality. It also asks for details of nursing education and which division of nursing registration is being applied for, such as general nurse, midwife, or nurse prescriber. A €200 administrative fee must accompany the completed form, which can be paid by credit card, cheque or bank draft. Only licensed recruitment agencies in Ireland are authorized to submit forms on behalf of applicants.

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    Request For Personalised Application Form For Registration With An Bord Altranais

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    ico_is
    16 views2 pages
    This document is a request form for a personalised registration application with An Bord Altranais (the Nursing Board of Ireland). It requests basic contact information such as name, date of birth, address, and nationality. It also asks for details of nursing education and which division of nursing registration is being applied for, such as general nurse, midwife, or nurse prescriber. A €200 administrative fee must accompany the completed form, which can be paid by credit card, cheque or bank draft. Only licensed recruitment agencies in Ireland are authorized to submit forms on behalf of applicants.

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    Irlanda Formular

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    This document is a request form for a personalised registration application with An Bord Altranais (the Nursing Board of Ireland). It requests basic contact information such as name, date of birth, address, and nationality. It also asks for details of nursing education and which division of nursing registration is being applied for, such as general nurse, midwife, or nurse prescriber. A €200 administrative fee must accompany the completed form, which can be paid by credit card, cheque or bank draft. Only licensed recruitment agencies in Ireland are authorized to submit forms on behalf of applicants.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    16 views2 pages

    Request For Personalised Application Form For Registration With An Bord Altranais

    Uploaded by

    ico_is
    This document is a request form for a personalised registration application with An Bord Altranais (the Nursing Board of Ireland). It requests basic contact information such as name, date of birth, address, and nationality. It also asks for details of nursing education and which division of nursing registration is being applied for, such as general nurse, midwife, or nurse prescriber. A €200 administrative fee must accompany the completed form, which can be paid by credit card, cheque or bank draft. Only licensed recruitment agencies in Ireland are authorized to submit forms on behalf of applicants.

    Copyright:

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    Download as PDF, TXT or read online from Scribd
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    REQUEST FOR PERSONALISED REGISTRATION APPLICATION FORM REQUEST FOR PERSONALISED FORMFOR FOR REGISTRATION WITH AN BORD ALTRANAIS REGISTRATION WITH AN BORD ALTRANAIS
    Please use block capitals when completing this form. A non-refundable administrative fee of 200 must accompany this request form. You may pay this fee by cheque, postal order, bank draft or complete the credit card/laser mandate overleaf.
    

    Nationality
    

    
    Country in which you undertook your education /training programme
    

     

    Title Miss/Ms/Mrs/Mr/other
    

    Surname
    

     

    Forename
      
    

    Date of Birth
    

    Contact Email Address


    

    Contact Telephone Number


    

     

    Personal Contact Address only or Name and Address of Authorised*Recruitment Agency Acting on Your Behalf
    

        
    * Only currently licensed Recruitment Agencies will be allowed to act on behalf of an Applicant. The Recruitment Agency must hold a current valid licence with the Department of Jobs, Enterprise and Innovation in Ireland.

     I hereby apply for Registration in the following Division(s) of the Register. (Please X appropriate box)
    

    General Nurse Midwife Psychiatric Nurse Intellectual Disability Nurse Childrens Nurse Public Health Nurse Nurse Tutor Nurse Prescriber
    Signature Date
    D D M M Y Y Y Y

     For office use only


        

    Reference No:

    Transaction No:

    Card Type
     

    (please tick as appropriate)

     Card Number Expiry Date Card Holder name as per card


     

     Signature of Cardholder
    

      

    Return completed form to: An Bord Altranais, 18/20 Carysfort Avenue, Blackrock, Co Dublin, Ireland
    

              

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