Application Form

To take part in our Oregon Registered Nurse (RN) or Licensed Practical Nurse (LPN) reentry programs, please fill out the application below.

MM slash DD slash YYYY
Your Nursing Degree
Do you have any limitations to doing clinicals?
Have you ever been in trouble with OSBN?
Max. file size: 300 MB.

See bottom of page for examples of acceptable photos.

Max. file size: 300 MB.
Please remember your Username and Password this is what will be used to log into the course.
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