APPLICATION: NCLEX: RN EXAM
   
INSTRUCTIONS
   
To apply to State of California BRN for the NCLEX-RN exam, you will need to complete the following:
   
First Step:
1. Download from the Board of Registered Nursing (BRN) website http://www.rn.ca.gov/ the Application for Licensure by Examination. Complete the form as directed.
   
2. You may submit the completed Application for Licensure by Examination to the BRN at any time. (Prior to mailing your application to the BRN make a photocopy of it.)
2.1 A completed application for the BRN must include the fingerprinting requirement. The BRN offers two methods for completing the fingerprinting requirement.
   
  a. “Live Scan” Application Process
     
  b. “Fingerprint Card (Hard Card)” Application Process
   
  The SFSU Police Department offers the “Live Scan” and the “Fingerprint Card (Hard Card)” fingerprinting service. You must call the SFSU Police Department at 415-338-6043 to make an appointment. For more detail information, please visit their website at http://www.sfsu.edu/%7Edps/html/fingerprinting.html 
   
Second Step:
During the semester you will need to submit the three forms listed below to: School of Nursing (BH 371):
A. The three forms may be downloaded from online at www.nursing.sfsu.edu or they are located in the following bins: Burk Hall 371
 
   
1) Request for Transcript (BIN #19): see instructions below on how to fill out this form
   
2) Individual Candidate Roster (BIN #18): see instructions below on how to fill out this form
   
3)  BRN Checklist (BIN #20)
   
 

3.1

The BRN Checklist must include:
     
 

a.

Nursing prerequisites grades
     
 

b.

 Nursing courses grades
     
  The BRN Checklist does not include N446, N447 and N555 because these courses are not required by the BRN for licensure. Those courses are required for the BSN degree at SFSU.
   
Instructions on How to Complete the Following Forms:
1. THE REQUEST FOR TRANSCRIPT: (You must attach an official transcript(s) with your application and BRN checklist to show proof of your above course grades.)
   
  Section A. TO BE COMPLETED BY APPLICANT
  1) Last Name- Fill in your Legal name
  2) First Name- Fill in your Legal name
  3) Address, City, State, Country and Postal/Zip Code- Fill in your current mailing address
  4) Date of Birth- Fill in (Month/Day/Year)
  5) Social Security Number- Fill in your nine digit numbers (Not your SFSU ID Number)
  6) Previous Name- Fill in your name if you have a different name previously, which includes Maiden Name
  7) Name of Professional Registered Nursing School- this will be San Francisco State University
  8) Years Attended- this refers to the year you have entered the SFSU nursing program to present (Example: Fall 2001- Present)
  9) Location- Will be San Francisco
  10) State- Will be CA
  11) Country- Will be USA
  12) Postal/Zip Code- Will be 94132
  13) Year Graduated- Fill in the Month, Date and Year of your graduation date. (Important: Please enter the actual date. The graduation date for Spring 2007 is June 1, 2007.)
  14) Signature of Applicant- you must sign this form
  15) Date- you must date this form with the day that you signed it
     
Section B. TO BE COMPELETED BY THE OFFICE OF THE SCHOOL OFFICAL RELEASING TRANSCRPTS (Please complete the following portion to assist the Nursing Director to complete the form correctly with your information.)
     
  1) Entrance Date- Fill in the semester you started at San Francisco State University
     
  2) Date Diploma/ Degree Awarded- Fill in the Month, Date and Year of your Diploma Awarded date and your nursing degree. (Ex: Spring 2007 Diploma date will be (June 1, 2007) and (BSN or MSN)
     
  3) Date Nursing Program Requirements Completed- Fill in the Completion date of the pre-licenser requirements, which is the semester last day of the instruction. (Ex: Spring 2007 will be (June 1, 2007)
     
  4) Name of School- Only applies to the Generic MSN Students. Fill in name of the school you have completed your previous degree.
     
  5) Type of Degree- Only applies to the Generic MSN Students. Fill in the title of your previous degree.
     
2.) THE INDIVIDUAL CANDIDATE ROSTER: Top Portion of the Form- Personal Information:
     
  1) Last, First and Middle Name- Fill in your Legal Name
     
  2) Date of Birth- Fill in (Month/Date/Year)
     
  3) Social Security Number- Fill in your nine digit numbers (Not your SFSU ID Number)
     
  4) Previous Names- Fill in your name if you have a different name previously, which includes Maiden Name
     
  5) School of Nursing- Will be San Francisco Sate University
     
     
 

Bottom Portion of the Form- Must Be Completed by the Nursing Program Director: (Please complete the following portion to assist the Nursing Director to complete.)

  1) Candidate’s Name- Fill in your Legal Name
     
  2) Please choose the appropriate options A, B or C that apply to you:
     
    A) BSN Students- Graduating from the Nursing program and the University by the end of the semester- Please check the box for Graduate Graduation Date- Fill in (June 1, 2007).
       
    B) BSN Students- Graduating from the Nursing program, but not graduating from the University by the end of semester- Please check the box for Non-Graduate Completion Date- Fill in the date of the last day of the semester that you have completed the nursing program requirements.
       
    C) Generic MSN Students- Completing the nursing pre-licenser requirements by the end of the semester- Please check the box for Master’s Entry Program in Nursing (MEPN)
Completion Date- Fill in the date of the last day of the semester that you have completed the nursing pre-licenser requirements.
Previous Degree- Fill in the title of your previous degree
Graduation Date- Fill in the date you graduated from your previous degree.
       

Third Step:
 1) After completing of the three forms you must make an appointment with your Nursing Advisor. 
   
2) Your advisor must sign the BRN Checklist form.
   
3) When the three forms are completed , then submit them to the front office staff BH 371.
   
4) During the last month of the semester, the Nursing Director will review and sign your three forms. (ONLY THE COMPLETED FORMS WILL BE SIGNED.)
   
5) The Individual Candidate Roster forms will be mailed as a group to the BRN by the office staff.
   
6) You must come to Burk Hall 371 starting the third week of June to PICK UP the Request for Transcript form that you previously submitted to the nursing office.
   
7) You MUST SUBMIT the signed Request for Transcript form to the Cashier’s office at the SSB-ONE STOP for payment. The Register office will then forward your official transcript and the Request for Transcript form to the BRN office.
   
8) Once the BRN office receives the list of items below then your NCLEX process is consider complete.
   
  1) Complete Application for Licenser by Examination
     
  2) Individual Candidate Roster form from the SFSU, School of Nursing
     
  3) Request for Transcript form with your official transcript from the SFSU
   
9) Approximately two weeks after your completion date of your NCLEX application process, the BRN will send a confirmation packet to you by postal mail. This conformation packet will include the information below regarding the registration for taking the NCLEX-RN examination:
   
  1) Confirmation of your eligibility
     
  2) Instructions
     
  3) Addresses
     
  4) Telephone Numbers
   
10) The issue date of your INTERIM PERMIT:
   
    BSN Graduates, your interim permit will be issue two weeks after your graduation date.
     
    Non-Graduates (Generic MSN Students), your interim permit will be issued two weeks after completing your nursing pre-licenser requirements.
   
11) Complete the NCLEX process promptly so that you will be eligible to take the NCLEX-RN examination in January or June prior to the following semester.
   
12) NCLEX results may take up to one month. The BRN will not release NCLEX-RN results over the telephone. (If you pass the NCLEX-RN examination, the BRN will notify you by postal mail regarding your license, continue education and re-licensing.)
   
13) After receiving your RN license, you may apply for the Public Health Nurse (PHN) Certificate through the BRN. For more details about the application (PHN Certificate), please refer to the BRN website at http://www.rn.ca.gov/.
   
   
 

Revised: 1/23/2007

 

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