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Nurse Form 1 Application for Licensure

Nurse Form 1. Application for Licensure The University of the State of New York The State Education Department Applicants Must Complete All Pages Of This Application In Ink Office of the Professions All applicants for Licensure must complete this form and submit it with the appropriate Licensure and Division of Professional Licensing Services registration fee ($143) directly to the Office of the Professions at the address at the end of this form. You must answer all questions and provide all information requested unless otherwise indicated. Failure to complete all required parts of the Application will delay its review.

16. If you have ever taken the SBTP, NCLEX, or a state-constructed examination for licensure as either a Registered Professional Nurse or a

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