Looking for a Alaska Legal Forms And Templates? Download it for free!

STATE OF ALASKA

DEPARTMENT OF COMMUNITY AND ECONOMIC DEVELOPMENT

DIVISION OF OCCUPATIONAL LICENSING

NURSE AIDE REGISTRY

3601 C STREET, SUITE 722

ANCHORAGE, ALASKA 99503-5934

(907) 269-8169

E-mail: license@dced.state.ak.us

APPLICATION FOR CERTIFIED NURSE AIDE BY EXAMINATION

Alaska Statute 08.68 is the statute related to nursing in Alaska; 12 AAC 44.800-12AAC 44.895 are the regulations set

forth by the Board of Nursing that govern certified nurse aides. A copy of the statutes and regulations are enclosed with

this application. Please read the appropriate rules and laws for certification by examination.

REQUIREMENTS

1. Successful completion, within five years immediately before the date of application, of a state approved certified nurse

aide training program.

2. Possession of an unencumbered nursing license, either current or lapsed, issued by a state or territory of the United

States or by a province of Canada.

3. Successful completion, within five years immediately before the date of application, of one year or more of nursing

education that includes both clinical and classroom instruction on nursing theory from a nursing school approved by a

state or territory of the United States or by a province of Canada.

4. Successful completion, within 10 years immediately before the date of application, of a United States corpsman or

medic training program and service in the United States military forces as a corpsman or medic within five years

immediately before the date of application; or

5. Successful completion of a nursing training program in a foreign country other than Canada. Applicants must submit

all required documents accompanied by certified English translations if the original documents are not in English.

APPPLICATION PROCEDURES

1. Submit a completed application, signed and notarized. The completed application which must include the Verification

of Training form and the Verification of Credentials form, if applicable, must be received in the Anchorage Division of

Occupational Licensing Office no later than two weeks prior to the examination date to allow for processing.

2. Attach one (1) recent passport sized (2 x 2) photograph, signed and dated on the back to page 2 of the application

form.

3. Attach a check or money order for $210 made payable to the STATE OF ALASKA. If your examination fee is being

paid at a later date by another entity other than yourself, please submit a copy of the voucher or purchase order

completed by the responsible party.

4. Complete Section I of the Verification of Training for the Alaska Nurse Aide Registry form. Submit the form to the

school or facility where you completed your nurse aide training program. The training program will complete the form

and return it to the Alaska Nurse Aide Registry.

5. Your state application must be approved before you will be allowed to sit for the examination. You will be notified in

writing approximately three weeks after receipt of your application concerning the status of your application.

SOCIAL SECURITY REQUIREMENT

Alaska Statute (AS) 08.01.060(b) and AS 08.01.100(b) require an applicant for an occupational license to provide a

United States Social Security Number. However, the Alaska Division of Occupational Licensing may, under certain

circumstances, issue a license to a foreign citizen who is unable to obtain a United States Social Security Number. To

apply for exemption from the social security number requirement, contact the Program Manager at (907) 269-8169.

08-4069 (Rev. 12/00)

(1)

Form 08-4069 - Application For Certified Nurse Aide By Examination - Alaska Department Of Community And Economic Development

Related Articles

Related forms

Related Categories