Application for general registration
for students completing an approved program of study Profession: Nursing and Midwifery
Part 7 Division 6 of the Health Practitioner Regulation National Law (the National Law)
This form is for students of Australian academic institutions who are completing their studies and who have never been registered or practised as a health practitioner in Australia or overseas. This is an application for general registration as an enrolled nurse, registered nurse or midwife in Australia. This application must be lodged, with all supporting documents, with the Australian Health Practitioner Regulation Agency (AHPRA) in the capital city of the state or territory where the approved program of study has been completed. It is important that you refer to the Nursing and Midwifery Board of Australia’s (the Board) registration standards before completing this application. Registration standards, codes and guidelines can be found at www.nursingmidwiferyboard.gov.au
Symbols in this form
Additional information Provides specific information about a question or section of the form.
Attention Highlights important information about the form.
Attach document(s) to this form Processing cannot occur until all required documents are received.
Signature required Requests appropriate parties to sign the form where indicated.
This application will not be considered unless it is complete and all supporting documentation has
been provided. Supporting documentation must be certified in accordance with AHPRA guidelines. For more information, see Certifying documents in the Information and definitions section of this form.
Privacy and confidentiality
Mail document(s) directly to AHPRA Requires delivery of documents by an organisation or the applicant.
Completing this form
• • • • • •
Read and complete all questions. Ensure that all pages and required attachments are returned to AHPRA.
Use a black or blue pen only.
Print clearly in B L OC K
L E T T E RS
Place X in all applicable boxes:
If you are completing this application on a computer you must use either Adobe Acrobat® or Adobe Reader® (version 7 or above).
DO NOT send original documents unless specified.
Do not use staples or glue, or affix sticky notes to your application. Please ensure all supporting documents are on A4 size paper.
SECTION A: Application criteria
What are you applying for general registration as?
Are you a new graduate or are you currently completing your studies relating to this application?
Mark all options applicable to your application
You must be a student of an Australian academic institution.
Go to the next question
You are not eligible to use this application form. To apply for general registration, you may need to complete AGEN-40 or AGOS-40, see www.nursingmidwiferyboard.gov.au for details.
3. Have you ever been registered or practised as a health practitioner in Australia or overseas?
Go to the next question
You are not eligible to use this application form. To apply for general registration, complete application form AGEN-40, which can be found at www.nursingmidwiferyboard.gov.au.
4. At what academic institution are you completing your study?
Name of institution
State/Territory VIC NSW
5. What is your student identification number?
Student identification number
Effective from: 9 September 2014
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