Emergency Registration and Licensure Online Application

Emergency Registration and Licensure Online Application
Street Address
Apartment, suite, unit, building, floor, etc.
5. Do you or will you have LPN employment in Saskatchewan on an emergency basis? If so, please indicate the employer name, location, and contact name and number.
6. If you answered yes to #5 above, do you have a letter of offer or documentation confirming the employment?
7. Are you currently registered and licensed as an LPN in another Canadian province?
8. Have you ever been charged with or convicted of a criminal offence?
9. Do you currently have a physical, mental, or emotional condition potentially posing a risk to your ability to provide safe, competent, and ethical nursing care?
Is the English language your first learned language, and the language used in the home as a child for reading, writing, listening, and speaking?
By checking yes, I declare all information on this form is true and correct.