Extension of Hours Request

2208 E Victoria Ave
Regina, SK  S4N 7B9
306-525-8026
registration@salpn.com 

According to the SALPN regulatory bylaw 10(1)(a), “In order to be eligible to obtain a renewal of a licence to practice, a member who is a licensed practical nurse must; have worked in LPN activities approved by the council for at least 1250 registered working hours during the previous five years, or such longer period that the registrar may approve in writing.”

For a variety of reasons, there are times when LPNs do not meet the SALPN’s minimum hour requirement.  When this occurs, LPNs may apply to the SALPN Registrar for additional time to accrue the minimally accepted practice hours.  Applications are assessed on a case-by-case basis.

View the SALPN Extensions Policy for more information here!

Extension of Hours Request
Personal Information

Address *
Address
City
State/Province
Zip/Postal
Extension Request

For the SALPN to properly assess an extension request, please:

a) Complete the application outlining your request and reason(s) why you have not met the minimum hour requirement. Please provide your explanation below or supporting documentation.

Explanation Document
Maximum upload size: 134.22MB
b) Submit documentation from your physician or another health professional, manager, employer which verifies your extended leave from work.
Documentation verifying your leave from work:
Maximum upload size: 134.22MB
c) Submit documentation from your employer, Human Resource (HR) department, or manager verifying the employment you will be returning to, if applicable.
Documentation verifying the employment you will be returning to
Maximum upload size: 134.22MB
d) Submit documentation from your employer, HR department, or manager verifying the hours you have worked, including overtime and statutory holidays, in the previous 5-year period, if applicable.
The Employer Verification can be found at the bottom of this form.

Documentation verifying the hours you have worked, including overtime and statutory holidays, in the previous 5-year period
Maximum upload size: 134.22MB
e) Submit a plan explaining how you intend to accumulate the required hours, including the anticipated date of completion. Provide an explanation below or upload supporting documentation.
Supporting Documentation
Maximum upload size: 134.22MB
f) Submit any other pertinent information you think may be helpful to the SALPN Registrar.
Supporting Documentation
Maximum upload size: 134.22MB
g) Pay the $100.00 application fee. Non-refundable.
DECLARE: *
Payment Information

Other Form of Payment. NOTE: Please include cash, cheque or money order with the paper application
The paper Application is available below.

Employer Verification Form

Extension of Hours Paper Application