Request for NMC Overseas Application Forms

(Please use BLOCK CAPITALS throughout this form)

Please use the space provided to confirm any PRN / PIN numbers you have previously been
issued:

All applicants who apply to become registered nurses with the NMC must demonstrate
competence in the English language by achieving a specific mark in the International English
Language Testing system (IELTS). Applicants must complete the academic version of the IELTS
test and achieve an overall average score of 7 (out of possible 9). For more details on this
mandatory requirement please refer to www.nmc-uk.org. If you have not met this standard
please do not send this request to the NMC until you have done so.

I tick to confirm I have met the above standard:

IELTS test report form number: ________________________________

Nationality:
F I L I P I N O

Title Miss / Mrs / Mr / Ms / Other

(Delete as appropriate) Please state

Date of Birth:
D D M M Y Y Y Y

Last Name:

First Names:

Present Address:
c/o Liz Miller
4/F Dorland House, 20 Regent Street. London SW1Y 4PH
Country of Registration:
P H I L I P P I N E S
I wish to apply for admission to the part of the Register of the Nursing and
Midwifery Council (NMC) on:
(Please X appropriate box)
Part 1 Registered Adult Nursing X
Part 3 Registered Mental Nurse
Part 5 Registered Nurse for the Mentally Handicapped
Part 8 Registered Sick Children’s Nurse
Part 10 Registered Midwife

Signature: ______________________

To complete this form, download it to your computer, fill it in and save it, then e-mail as an attachment to
mailto:overseasapplication@nmc-uk.org.

PLEASE DO NOT SEND ANY FEE TO THE NMC AT THIS STAGE.