Application Form Eng (1)

7/25/2019 Application Form Eng (1)

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The Nursing Council of Hong Kong

Application for Registration (Sick Children)

under the Nurses Registration Ordinance, Cap. !"

(for nurses trained outside Hong Kong)

Application Notes

1 Who can apply?1.1 Nurses trained outside Hong Kong who:

1.1.1 have attained the minimum age of 21 years;1.1.2 have successfully completed one of the following programmes:

a preregistration children!s nursing fulltime programme of not less than# acade$ic %ears or e&ui'alentat a university" college" polytechnic or othertraining institute as recogni#ed $y the Nursing %ouncil of Hong Kong &'the%ouncil() from time to time; or

other fulltime programme&s) of paediatric and adolescent nursing" speciallydesigned for nurses having a *ualification of +egistered Nurse &,eneral) while

-oining the programme as approved $y the %ouncil from time to time" and theprogramme must not $e less than acade$ic %earin length;

1.1. are of good character; and1.1./ possess valid certificate&s) to practise nursing and care of sic0 children Note 1issued

$y such certifying $ody as may $e recogni#ed $y the %ouncil from time to time asconstituting sufficient evidence of hisher competency to practise nursing and careof sic0 children at the time of hisher application.

Note 1: The certificate to practise nursing and care of sick children must be valid at the time

of application. The Council will not process any application that fails to produce such

document.

2 pplication 3rocedure2.1 4he applicant should complete the application form and su$mit originals and photocopies

or notari#ed copies Note 2of the following:2.1.1 Nursing graduation certificate&s)2.1.2 Hong Kong 5dentity %ard3assport2.1. 6alid certificate&s) to practise nursing from local registration authority&i.e. &i) practising certificate&s) or other e*uivalent documentary evidence of

entitlement to practise as a +egistered Nurse &7ic0 %hildren) andor a

+egistered Nurse &,eneral) outside Hong Kong; and&ii) registration certificate as a +egistered Nurse &7ic0 %hildren) andor a+egistered Nurse &,eneral) or official document from localregistration authority verifying the applicant!s 'date of initialregistration(.)

Note 2: If the applicant submits the application in person he!she has to bring the originals

and photocopies of the above items to the Council for verification. The original

documents will be returned immediately after verification of the photocopies

submitted. If the applicant submits the application by post he!she is re"uired to send

true copies of these documents duly legali#ed!authenticated by notari#ation to the

Council.

2.2 4he applicant should re*uest the training institute&s) to send us hisher transcript&s)stating clearly the course code" full name and graderesult of each attended su$-ecttogether with a separate record of detailed $rea0downs in theoretical and clinical training

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hours of each su$-ect. 7ince some of the re*uired information may not $e shown on thetranscript&s) of the individual applicant" in order not to delay the application" the applicantshould also as0 the training institute&s) to complete and return to the %ouncil direct the'6erification of 4raining etails( on pages 9 to of the application form in an officialand sealed envelope of the training institute.

2. 4he applicant should also send the '6erification of icensing @amination only if heshe has fulfilled the re*uirements of the %ouncil.

2.A eadline of application:

2.A.1 While applications are processed all year around" only those duly completedapplications with all the re*uired documents received $y the %ouncil % the endof Octoer each %ear will $e assessed and the applicants concerned will $enotified whether they are eligi$le to sit for the >icensing @amination to $e heldne@t year.

2.A.2 4he %ouncil will assess the application onl% hen all re&uired infor$ation anddocu$ents are pro'ided" including items 2.1 to 2. a$ove.

2.B %ommonly identified issues resulting in a delay of application:2.B.1 5ncomplete information

2.B.1.1 4he applicant needs to fill out the application form entirely and

su$mit all re*uired documents.2.B.1.2 n application cannot $e processed until all information and

documents are received.2.B.1. 3lease remem$er to write your full name where necessary.

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2.B.2 Cismatched information $etween documents2.B.2.1 5nformation such as names" date of $irth" dates of education" etc.

provided $y the applicant must match with the supporting documentssu$mitted $y the training instituteregistration authority.

2.B.2.2 ny discrepancies will need to $e clarified $efore the application can

$e processed further.2.B. >ac0 of documentary proofs

2.B..1 4he re*uired documentary proofs andor supplementary proofs are notprovided.

2.B..2 4he documentary proofs are in languages other than nglish %hinese &ifthe original documents are in other languages" officialcertified translationin nglish must $e provided simultaneously).

2. fter an applicant has completed the application form" heshe is re*uired to su$mit it"together with the documents re*uired" either in person or $y post" to the 7ecretariat of the

Nursing %ouncil of Hong Kong" 1D" 7hun Deng 5nternational %entre" 1B2 Eueen!s +oadast" Wanchai" Hong Kong. pplications sent $y fa@ or email will not $e processed. 4heoffice hours of the 7ecretariat are as follows:

Condays: :88 a.m. to 1:88 p.m. and 2:88 p.m. to 9:88 p.m.4uesdays to Dridays: :88 a.m. to 1:88 p.m. and 2:88 p.m. to =:/= p.m.&%losed on 7aturdays" 7undays and 3u$lic Holidays)

2.18 Dor any en*uiries" please contact the staff of the %ouncil 7ecretariat at &B=2) 2=2A B=1during office hours" or $y email to ncFdh.gov.h0.

@amination rrangement

.1 Dormat:.1.1 4he >icensing @amination for +egistration &7ic0 %hildren) normally consists of

the written and practical parts. 4here will $e no e@emption for any part of the>icensing @amination.

.1.2 4he applicant must pass the written part $efore heshe will $e allowed to ta0e thepractical part" and must pass $oth parts of the >icensing @amination $eforeheshe can register with the %ouncil.

.2 4ime frame in ta0ing the >icensing @amination for eligi$le applicants:

.2.1 4he applicant is re*uired to ma0e hisher first attempt of the >icensing@amination within two years from the date the %ouncil issues its initial approvalfor sitting the >icensing @amination to himher. pplications for deferment

$eyond the twoyear limit will normally not $e entertained..2.2 5f the applicant fails to pass any part of the >icensing @amination" heshe is

re*uired to resit the failed part only. Nevertheless" the applicant has to resit thefailed part within one year from the date of hisher last attempt" e@cept with thespecial permission of the %ouncil and su$-ect to such conditions as to training orinstruction as the %ouncil may impose.

.2. 5f the applicant fails to pass the practical part of the >icensing @amination withinthree years from the date heshe passes the written part" heshe needs to resit $oth

the written and practical parts..2./ 5f the applicant fails to pass the >icensing @amination on three occasions" heshe

will not $e entitled to resit the >icensing @amination again without the specialpermission of the %ouncil. 7uch applications for special permission should $e

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sent to the %ouncil within two wee0s of the date of the result notification letter.pplications received after the twowee0 period will normally not $e entertained.7u$mission of a fresh application does not mean an applicant will $e given furtherchances to resit the >icensing @amination. 4he following are some of thee@amples cited for reference:

7cenario 1 : 1stattempt pass in the written part

fail in the practical part2ndattempt fail in the reta0e of the practical partrdattempt fail in the reta0e of the practical part

7cenario 2 : 1stattempt fail in the written part2ndattempt pass in the reta0e of the written part

fail in the practical partrdattempt fail in the reta0e of the practical part

7cenario : 1stattempt fail in the written part2ndattempt fail in the reta0e of the written partrdattempt pass in the reta0e of the written part

fail in the practical part

7cenario / : 1stattempt fail in the written part2ndattempt fail in the reta0e of the written partrdattempt fail in the reta0e of the written part

. 7chedule of >icensing @amination:4he %ouncil normally organi#es the written part of the >icensing @amination inCarch and practical part in Gune every year respectively.

./ 4he 7ecretariat will inform applicants of the details of the application proceduresand payment method for the >icensing @amination in writing directly.

.= 4he e@amination fee is HKB98 for the >icensing @amination for +egistration&7ic0 %hildren). Dees are su$-ect to revision and are not refunda$le.

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*oints to Note for Co$pleting the Application +or$

5. pplication Dorm

i. 4he name of the applicant appearing on the application form and 4estimonialas to %haracter must $e identical as the name shown on the applicant!s HongKong 5dentity %ard or passport.

ii. pplicant should affi@ a recent photograph onto the photograph $o@ on theapplication form.

55. 4estimonial as to %haracter

i. 4he testimonial on page = of the application form must $e completed $y aperson who is not a family mem$er or relative of the applicant.

ii. 4he person completing the testimonial &Note: NOT the applicant) mustprovide hisher Hong Kong 5dentity %ard num$er or passport num$er in full.

iii. 4he person completing the testimonial &Note: NOT the applicant) must dulysign the form.

iv. 4he date of the 4estimonial as to %haracter must $e within 1 month from thedate of the application form.

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Checklist of ocu$ents Re&uired for the Application

*lease check if %ou ha'e enclosed the folloing docu$ents-

1%ompleted pages 1 to = of the pplication Dorm$see %&oints to Note for Completing the 'pplication (orm) on page v of the 'pplication Notes*

2Notari#ed %opy of Hong Kong 5dentity %ard3assport$ see paragraph 2.1 of the 'pplication Notes*

Notari#ed %opy of Nursing ,raduation %ertificate&s)$see paragraph 2.1 of the 'pplication Notes*

/Notari#ed %opy of +egistration %ertificate&s)$see paragraph 2.1 of the 'pplication Notes*

=Notari#ed %opy of %ertificate&s) to 3ractise Nursing3ractising %ertificate&s)$see paragraph 2.1 of the 'pplication Notes*

*lease re&uest %our Training nstitute (s) to send the folloing docu$ents to the Council direct

in an official and sealed en'elope of the Training nstitute(s)

1


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TH/ N0RSN1 CO0NC2 O+ HON1 KON1

APPLICATION FORM FOR NURSES (Sick

Children) TRAINED OUTSIDE HONG KONGfor registration3enrol$ent under the Nurses Registration Ordinance, Cap. !"

&Note: 1. 3lease read the Application Notes and *oints to Note for Co$pleting the

Application +or$carefully.2. 3lease fill in this form in print or typed letters).J 3lease only put


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Carital 7tatus: Carried 7ingle


9/17

. *rofessional nursing &ualifications

4itle +egistration licensing authority +egistration num$er Mear

o$tained

e.g. +egisteredNurse 7ic0

%hildren

Nursing Cidwifery %ouncil" IK +N%: 8OK88OO2 2818

/. Nursing e5perience since registration

*lease gi'e details of post6asic nursing e5perience, e.g. sick children, paediatric $edical,

paediatric surgical, adolescents ith sustance ause, etc.

Name and address ofhospital&s)

Wor0ing 3eriod3osition

heldNature of wor0

Drom&CCMM)

4o&CCMM)

. 5 enclose originals and photocopies or notari#ed copiesL

of the following: 3lease tic0

&a) Nursing graduation certificate&s)

&$) Hong Kong 5dentity %ard3assport

&c) 6alid certificate&s) to practise nursing from local registration authority or othere*uivalent documentary evidence of entitlement to practise nursing outsideHong Kong &i.e. +egistered Nurse &7ic0 %hildren) andor +egistered Nurse&,eneral) certificate&s))

&d) +egistration certificate&s)

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/. 4estimonial&s) from employer&s) certifying my nursing practice in sic0 children as indicated in thisapplication form isare provided on an optional $asis to facilitate the %ouncil!s consideration of myapplication for registration.

=. 5 am prepared to pay the registration and e@amination fees re*uired $y the %ouncil" sit for the >icensinge@amination and fulfill other re*uirements as specified $y the %ouncil" in the event of my application

$eing approved.

9. 5 agree to provide a 'statutory declaration( to verify that the names in the documents that the %ouncilreceived for my application for registration if the name appeared differently on my su$mitteddocuments.

7. eclaration

5 declare that the information given $y me on pages 1 to / of this application form is true to the $est ofmy 0nowledge.

Note: 'ccording to section 1, of the Nurses -egistration rdinance Cap. 1/0 aws of ong 3ong if

after due in"uiry the Council is satisfied that any registered nurse has obtained registration by

fraud or misrepresentation the Council in its discretion may order that:

$i* the name of the registered nurse be removed from the register4

$ii* the name of the registered nurse be removed from the register for a specified period4 or

$iii* such registered nurse be reprimanded.

3lease affi@ applicant!s

recent photograph here

7ignature of applicant:

Name of applicant:

&nglish)

&%hinese)

ate &CCMM)

3lease +4I+N this Dorm to:

4he 7ecretary

Nursing %ouncil of Hong Kong1D" 7hun Deng 5nternational %entre1B2 Eueen!s +oad astWanchai

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Hong Kong

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4o: 4he 7ecretary

Nursing %ouncil of Hong Kong

1D" 7hun Deng 5nternational %entre

1B2 Eueen!s +oad ast

Wanchai

Hong Kong

TESTIMONIAL AS TO CHARACTER

5 here$y state that 5 am not a family mem$er or relative of

&name of the applicant). 5 certify that 5 have 0nown &name of the applicant)

personally for years and that Jhe she is of good moral character.

+C+K7 &if any):

7ignature:

Dull Name:$in 5lock etter*

Hong Kong 5dentity %ard 3assport No. PNote 1Q:

%orrespondence

address:


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8/R+CATON O+ TRANN1 /TA2S +OR R/1ST/R/ N0RS/ (SCK CH2R/N)

(to e co$pleted % School *rincipal 3 Course 2eader of Nursing School 3 Training nstitute Note 1)

4o: 4he 7ecretary" Nursing %ouncil of Hong Kong1D" 7hun Deng 5nternational %entre

1B2 Eueen!s +oad astWanchai" Hong Kong

Note 1: 3lease fill in this form in print or typed letters in N,>57H %hinese.

Name of 7tudent : &7urname) &Caiden Name)

&Dorenames) 7e@:

ate of Rirth: SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS

Name and ddress of 7chool :

Name of the Nursing 3rogramme :

uration : years

%ommencement ate : &CCMM)

%ompletion ate: &CCMM)

JCode of 7tudy : Dulltime 3arttime

istance >earning


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Su9ect Areas Hours

. Riological 5ntegrated 7ciences:

natomy 3hysiology

Cicro$iology

3harmacology

Nutrition ietetics

Total -

/. 3rofessional Nursing:

History of Nursing

3hilosophy and Nursing 4heories Codels

thics and 3rofessional 5ssues

>egal spects

Nursing +esearch

Total -

=. 3rinciples 3ractice of Nursing:

3aediatric Nursing

- Damilycentred %are

- traumatic %are

-4heories of growth and development

- %hildren!s rights

- %hild a$use and the related roles of the nurse

- 3lay therapy

dolescent Nursing:

- %ommon conditions affecting nutrition and weight

- 3sychosomatic illness

- 7e@uality and teenage pregnancy

- 7e@ually transmitted diseases

7u$stance a$use

Rasic Nursing 70ills

3erioperative nursing

Dirst id mergency Nursing

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Su9ect Areas Hours

5llness prevention and health restoration of children with

alteration in various $ody system functions" including :

- 3reventive 3romotive +eha$ilitative %are

-Nursing 3rocess and Nursing iagnosis

- Health ssessment

- 3aediatric Cedical Nursing

- 3aediatric 7urgical Nursing

- 3alliative %are Nursing

- Haematology and earning" 3atient ducation

%hild Cental Health Nursing

%ommunity Nursing

%omplementary and alternative therapies

Total-

9. 5ntroduction to Nursing Canagement including:

ecision Ca0ing 3ro$lem 7olving

3lanning and


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. dolescent Nursing and 7u$stance $use

/. 3aediatric Cental Health Nursing

=. eaderNote 2:

Dull name in $loc0 letter Note 2:

ate &CCMM):

3lease stamp official seal of the school in the space provided.

+emar0s:3lease send the following documents together with the duly completed form in an officialand sealed envelope of your training institute 5+%4>M to the 7%+4+M" NI+75N,%


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8/R+CATON O+ OR1NA2 R/1STRATON O0TS/ HON1 KON1

4o: 4he 7ecretary" Nursing %ouncil of Hong Kong1D" 7hun Deng 5nternational %entre1B2 Eueen!s +oad astWanchai" Hong Kong

TO 4/ CO:*2/T/ 4; AN O++C/R O+ TH/ R/1STRATON A0THORT; (N 42OCK

2/TT/RS )

3lease confirm the +egistration details of the nurse sending you this form $y filling in the space provided.fter completion" please stamp the official seal of your +egistration uthority in the space provided $elowand send this form to the Nursing %ouncil of Hong Kong directat the address given a$ove in an official and

sealed envelope of your +egistration uthority.

Documents

Application Form Eng (1)