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Maryland Nursing Assistant Program GERIATRIC NURSING ASSISTANT Application FOR REGISTRATION BY EXAMINATION Please Print legibly ? use ink only This application must be completed if you wish to apply.

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How to fill out the FOR REGISTRATION BY EXAMINATION online

This guide provides clear instructions on completing the FOR REGISTRATION BY EXAMINATION form for the Maryland Nursing Assistant Program. Following these steps will help ensure your application is accurate and complete, facilitating your registration for the exam.

Follow the steps to successfully complete the application form.

  1. Click ‘Get Form’ button to obtain the form and open it in your preferred online editor.
  2. Begin by entering your personal information in the designated fields. This includes your legal name, date of birth, and social security number. Ensure that you write your name exactly as you want it displayed on your nurse aide registration.
  3. Select your gender and provide your email address, ensuring it is valid for communication purposes.
  4. Fill in your current mailing address completely, including street number, city, state, and zip code. Additionally, provide your home and work phone numbers.
  5. Choose the examination type by checking the appropriate box that corresponds to the exam you need to take. Be aware that if you are applying for the first time, you must check both the Written or Oral Examination alongside the Skills Evaluation.
  6. Enter the fees associated with your chosen examination type as indicated, ensuring payment methods are properly selected. Note that payment must be made via certified check, company check, or money order, made out to 'American Red Cross'.
  7. Complete the eligibility route section by checking the appropriate box that reflects your current status. Attach any necessary documents such as achievement awards or transcripts as required.
  8. Provide the name, location, and details of your training program in the training program affidavit/completion certification section.
  9. Indicate your preferred test site by checking the appropriate box and supplying the necessary test site code and city.
  10. Complete the statistical information section, describing your race, highest level of education completed, and primary language.
  11. Sign and date the applicant's affidavit, confirming that all provided information is true and complete.
  12. Mail your completed application along with the necessary attachments and fees to the specified address of the American Red Cross.

Start completing your FOR REGISTRATION BY EXAMINATION online today!

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Application and Registration Process APPLICATION AND EXAMINATION FEE SCHEDULEPAYABLE TO THE USPTO1. CHOOSE ONE APPLICATION FEE:Application fee under 37 CFR § 1.21(a)(1)(i)$110Application fee for moral character issues under 37 CFR § 1.21(a)(10)$16802. CHOOSE ONE EXAMINATION FEE:12 more rows • Aug 7, 2017

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