APPLYREADY - DHA Applicant Form - How to Apply for NCLEX for International and Foreign Nurses, Requirements and Steps for NCLEX NPTE PROMETRICS HAAD UK-CBT DHA IELTS

1) Application Type and Sponsorship Information

Facility Name (if sponsored by a facility): *

Application for: *

Specialty: *

2) Personal Details

* Indicates required field

First Name: *

Middle Name *

Last Name: *

Maiden Name (if applicable): *

Date of Birth: *

Place of Birth: *

Passport Number: *

Nationality: *

UAE Identity Card Number (if applicable): *

Gender: *

Mailing Address: *

Line 1

Line 2

City

State

Zip Code

Country

City: *

Zip/Postal: *

Area/District: *

Country: *

Applicant Telephone Number: +971 – 05 - *

Facility PRO/applicant Representative Tel Phone Number (if applicable): *

Applicant Email Address: *

Facility/Authorized representative Email Address (if applicable): *

3) EDUCATIONAL QUALIFICATIONS

INTERSHIP (IF APPLICLABLE)

University/Institution Name: *

College Name: *

University Address: *

City: *

Area/District: *

Country: *

Telephone Number: *

Qualification Attained: *

Major Subject/s: *

Minor Subject/s: *

Attendance Period From: *

To: *

Qualification Conferred/Date issued: *

BACHELOR/ASSOCIATE DEGREE

University/Institution Name: *

College Name: *

University Address: *

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Line 2

City

State

Zip Code

Country

City: *

Area/District: *

Country: *

Telephone Number: *

Qualification Attained: *

Major Subject/s: *

Minor Subject/s: *

Attendance Period From: *

To: *

Qualification Conferred/Date issued: *

DIPLOMA COURSE

University/Institution Name: *

College Name: *

University Address: *

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Line 2

City

State

Zip Code

Country

City: *

Area/District: *

Country: *

Telephone Number: *

Qualification Attained: *

Major Subject/s: *

Minor Subject/s: *

Attendance Period From: *

To: *

Qualification Conferred/Date issued: *

POST GRADUATE DEGREE

University/Institution Name: *

College Name: *

University Address: *

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Line 2

City

State

Zip Code

Country

City: *

Area/District: *

Country: *

Telephone Number: *

Qualification Attained: *

Major Subject/s: *

Minor Subject/s: *

Attendance Period From: *

Qualification Conferred/Date issued: *

4) LICENSE INFORMATION

Issuing Authority: *

City: *

Area: *

Country: *

Professional Title/License Attained: *

License Type: *

License Status: *

License Number: *

Date Issued: *

Expiration Date: *

4) PROFESSIONAL EXPERIENCE DETAILS

FIRST EMPLOYER DETAILS

Name of Employer: *

Is the employer based of UAE? *

Yes No

Address: *

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Line 2

City

State

Zip Code

Country

Country: *

Website Address (URL): *

Period of Employment From: *

To: *

Job Title/Designation: *

Type of Employment: *

Full Time Temporary

SECOND EMPLOYER DETAILS

Name of the Employer: *

Is the employer based out of UAE? *

Yes No

Address: *

Line 1

Line 2

City

State

Zip Code

Country

Country: *

Website Address (URL): *

Period of Employment From: *

To: *

Job Title/Designation: *

Type of Employment *

Full Time Temporary

THIRD EMPLOYER DETAILS

Name of the Employer: *

Is the employer based out of UAE? *

Yes No

Address: *

Line 1

Line 2

City

State

Zip Code

Country

Country: *

Website Address (URL): *

Period of Employment From: *

To: *

Job Title/Designation: *

Type of Employment *

Full Time Temporary

FOURTH EMPLOYER DETAILS

Name of Employer: *

Is the employer based out of UAE? *

Yes No

Address: *

Line 1

Line 2

City

State

Zip Code

Country

Country: *

Website Address (URL): *

Period of Employment From: *

To: *

Job Title/Designation: *

Type of Employment *

Full Time Temporary

FIFTH EMPLOYER DETAILS

Name of the Employer: *

Is the employer based out of UAE? *

Yes No

Address: *

Line 1

Line 2

City

State

Zip Code

Country

Country: *

Website Address (URL): *

Period of Employment From: *

To: *

Job Title/Designation: *

Type of Employment *

Full Time Temporary

Submit

​1) ​Application Type and Sponsorship Information

2) Personal Details

3) EDUCATIONAL QUALIFICATIONS

4) LICENSE INFORMATION

4) ​PROFESSIONAL EXPERIENCE DETAILS

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1) Application Type and Sponsorship Information

4) PROFESSIONAL EXPERIENCE DETAILS

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