Nursing Education Initiative Application Form

Step-1 Eligibility

* Mandatory fields.

College of Nurses of Ontario Registration Number

(If you are dually registered, tick both boxes and submit both CNO registration numbers. You may apply to only one professional association).

RPN

Applicant Information

First Name*

Last Name*

Telephone*

Personal Email*

Address*

City*

Province*

Postal Code*

Professional Development Course Application

SUBMISSION DEADLINE: The completed application must be received within 90 days of the completion date of the course/conference. This deadline is strictly observed. Late or incomplete applications will be declined.

Education Type*

Complete the following table. Please apply on a course-by-course basis. All necessary boxes must be completed or the application will be declined. Check off “Other” if you are applying for a non-nursing specific course/conference. Programs should be broken down into individual courses. Please use the Add Course option below to add additional course(s).

Course/Conference*

Course Code (if applicable)

Educational Provider*

Education start date*

Education end date*

Tuition/Conference Registration Fee*

FileUpload - Required Documents *

NOTE: The size limit for uploading of each file is 5 MB.

Proof of Completion - Scanned certificate,transcript, etc. (PDF/Word format)

Proof of Payment - Scanned receipt (PDF/Word format)

Additional document - (optional)

Tuition Reimbursement

Have you or will you receive reimbursement from any other source for the registration/tuition fees for which you are applying for NEI funding?*

Add Course

Please provide missing information