Graduate Licensed Practical Nurse Application Form for Internationally Educated Nurses

Graduate Licensed Practical Nurse Application Form for Internationally Educated Nurses
Personal Information
Address
Address
City
State/Province
Zip/Postal
Country
Education
Did you complete the courses at Saskatchewan Polytechnic as required per your IEN assessment performed by the SALPN?
If yes, did you provide the CLPNS with your official transcripts?

Maximum file size: 268.44MB

Identification

Upload two pieces of Government issued ID – one must be photo. You can use your mobile phone camera to take the pictures, however, ensure that it is a clear image.
The following are acceptable forms of identification:

  • Driver’s license
  • Saskatchewan Provincial ID card
  • Valid passport
  • Permanent residence card
  • Marriage certificate
  • Treaty status card
  • Canadian forces identification card

Social Insurance Number (SIN) cards are NOT accepted.

 

Maximum file size: 268.44MB

Maximum file size: 268.44MB

Criminal Record Check

The CLPNS requires a recent criminal record check for your GLPN application. 

Please upload a criminal record check that has an issue date of within 6 months of today’s date.

Only criminal record checks from Local Police Departments or Local RCMP Detachments are accepted. The CLPNS will not accept checks from other sources.

You will not be able to submit your application for review without a criminal record check.

If you have an unsatisfactory criminal record check, the CLPNS will require additional documentation. If this applies, further details will follow.

Maximum file size: 268.44MB

Duty to Report

LPN Practice Standard 1: Professional Accountability and Responsibility

Indicator 1.5: Have a duty to report any circumstance that potentially and/or actually impede professional, ethical, or legal practice

Do you have or been advised that you have, a physical, cognitive, mental or emotional condition which in any way may reasonably be expected to pose a risk of harm to yourself or clients or negatively impact your work as a Licensed Practical Nurse?
Declarations
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