***Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit.***
1
Do you possess a current license as a Registered Nurse from the Maryland State Board of Nursing, or a license recognized by the Multi-State Compact agreement?
Yes
No
2
If you responded Yes to question 1, please provide your license number and full expiration date in the box below. If your license is from a compact state, please provide a copy of your license or license verification. Enter N/A if this question does not apply to you.
3
Do you possess a bachelor's degree in nursing or a related field?
Yes
No
4
What is the major field of study for your bachelor's degree? If you answered "No" to the previous question, please enter N/A in the box.
5
Do you possess a master's degree in nursing or a related field?
Yes
No
6
What field of study is your master's degree in?
7
Do you have experience providing nursing care to patients who are receiving either hemodialysis or peritoneal dialysis?
Yes
No
8
If you responded YES to the above question, please describe your work experience providing nursing care to patients who are receiving hemodialysis or peritoneal dialysis. This experience should also be included in your application.