SINGAPORE NURSING BOARD

Declaration by Applicant for Overseas Licensure Examination

Name: Nursing Registration/ Licence No:

I declare the following:

Please “√” accordingly
Yes No
1. Have you ever sat for SNB Licensure Examination?
If yes, please provide information:

Type of Exam Date of Exam (Month and Year)

EN / RN
EN / RN

2. Do you have any existing applications for enrolment / registration with SNB?
If yes, please provide information:

Type of Application Name of Institution Year

EN / RN
EN / RN

3. Have you ever been enrolled / registered with SNB?

If yes, please provide SNB Registration No:__________________________

4. Have you ever worked in Singapore?

If yes, please provide information:
Name of Employer:_____________________________________________
Designation:__________________________________________________
Period of Employment: __________________________________________

I declare that the information provided above is true and correct. I have not withheld any material
information to the best of my knowledge. I acknowledge that providing false information, statements and
declaration will affect my eligibility to apply/ re-apply for enrolment/registration with Singapore Nursing
Board.

I am in full knowledge that my application for enrolment/registration with SNB will be dependent on SNB’s
assessment and passing the SNB Licensure Examination does not automatically admit me to enrol/register
with SNB.

________________________________ _____________
Signature of Applicant Date
Name of Institution:
Date of SNB Licensure Examination:

HR to Note:
For any applicant who had ever sat for SNB licensure examination, or had any application with SNB, or had ever
enrolled / registered with SNB, please notify SNB before allowing the candidate to sit for exam.

As of 20 July 2018