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Out of State Nurse Application 2026
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- Click ‘Get Form’ to open the Out of State Nurse Application in the editor.
- Begin by entering today’s date at the top of the form. Then, fill in your full name, including first, middle, and last names.
- Provide your complete address, including street, apartment number (if applicable), city, state, and ZIP code.
- Enter your email address and telephone number. Ensure that all contact information is accurate for future correspondence.
- Input your Social Security Number and list any states where you have been certified as a CNA. If your name has changed, attach legal documentation.
- Complete the demographic information section regarding sex, race, height, eye color, and date of birth for identification purposes.
- Answer questions regarding any administrative findings or criminal offenses. Provide detailed explanations if applicable.
- Sign and date the application at the bottom before submitting it to Southern Illinois University Nurse Aide Testing.
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For out-of-state testers, because an official transcript is needed, most will aim to complete all application paperwork by one month following graduation.
Out-of-State Nurse Aide Application to Become an Illinois Certified Nurse Aide (CNA) Phone: 877-262-9259 Fax: 618-453-4300 Email: inat@siu.edu. Nurse Aide