Get Aprn_app_only - The State Of Connecticut Website

This guide will assist you in completing the APRN_APP_Only form required for obtaining an APRN license in the state of Connecticut. Follow the steps outlined to ensure a smooth and accurate submission of your application online.

Follow the steps to successfully fill out the APRN application form online.

1. Click 'Get Form' button to obtain the form and open it in the editor.
2. Tape a recent photo of yourself in the designated area on the application. Ensure the photo is recent and meets the required specifications.
3. Fill in your first name, middle initial, last name, and maiden name, if applicable.
4. Provide your email address and telephone number for contact purposes.
5. Input your street address, city, state, and postal code.
6. Enter your date of birth and gender by checking the appropriate box.
7. Supply your Social Security number for identification.
8. Indicate your ethnicity by checking either 'Hispanic or Latino' or 'Not Hispanic or Latino'.
9. Select applicable options for race; check all that apply.
10. Answer the questions regarding previous APRN licenses in other states and provide details as necessary.
11. List your master's degree in nursing information, including the school name, city, state, and degree date.
12. Select the board for your current certification and include the certification number.
13. Address any disciplinary actions or complaints by answering the specified questions accurately.
14. If any questions related to professional history are answered with 'yes,' prepare a separate notarized statement with relevant documentation.
15. Complete the notarization section by signing and obtaining the signature of a notary public near the end of the form.
16. Review the entire application for accuracy and completeness before submission.
17. Save your changes, download a copy of the form, and print for your records. Share the completed application via mail to the specified address.

Complete your APRN application online today for a timely processing!