Get Program Change - Faculty Data Form - Maryland Board Of Nursing - Mbon

The Program Change - Faculty Data Form is a critical document for updating faculty information within nursing programs approved by the Maryland Board of Nursing. This guide will provide you with clear, step-by-step instructions to fill out this form accurately and efficiently online.

Follow the steps to complete the form successfully.

1. Press the ‘Get Form’ button to access the Program Change - Faculty Data Form.
2. Begin by entering the name of the applicant in the designated field. Ensure the name is spelled correctly as it appears on official documents.
3. Input the Maryland nursing license number in the appropriate section to verify the applicant's credentials.
4. Provide the program provider’s name and full address, ensuring that all details are accurate and up to date.
5. Enter the applicable phone number for the program provider to facilitate contact.
6. Fill in the program number in the specified field to link the faculty change with the correct program.
7. Check all relevant boxes under 'Application for' to indicate the roles applicable to the individual ( e.g., Program Director, Program Coordinator, etc.).
8. Have the applicant sign and date the form where indicated. This signature confirms the authenticity of the details provided.
9. For nursing faculty only, indicate if there are any practice limitations on the license and confirm attendance at the Train-the-Trainer Program if applicable.
10. Answer whether the applicant has previously taught in a nursing or vocational program, if required.
11. In the event of resignation or termination, complete the section with the date and any necessary comments.
12. After all sections are completed, review the form for accuracy. Make any necessary corrections before submitting.
13. Finally, save the changes made to the form. You can then download, print, or share the completed document as needed.

Ensure your faculty data is current by completing the Program Change - Faculty Data Form online today.