ENDORSEMENT 90-DAY TEMPORARY RN LICENSE APPLICATION 2025

1. Click ‘Get Form’ to open the ENDORSEMENT 90-DAY TEMPORARY RN LICENSE APPLICATION in our editor.
2. Begin by filling out the APPLICANT INFORMATION section. Enter your first name, middle name, last name, and any maiden or legal names. Provide your street address, city, state, zip code, and contact information including phone numbers and email.
3. Attach a passport-style photo as specified. Ensure it captures only your head and neck.
4. Proceed to EDUCATION INFORMATION. Fill in details about your high school education and any General Equivalency Development (GED) if applicable.
5. Complete the BASIC NURSING PROGRAM INFORMATION section with your nursing school details including name, city, state, graduation date, and degree type.
6. Answer the GENERAL APPLICATION QUESTIONS truthfully regarding advanced practice certification and previous licensure in other states.
7. Review the EMPLOYMENT section to provide information about your current or most recent employer.
8. Carefully answer all ELIGIBILITY QUESTIONS. If you answer 'Yes' to any question, prepare to attach explanations and certified documents as required.
9. Sign the ATTESTATION STATEMENT confirming that all provided information is accurate before submitting your application.
10. Finally, mail the completed application along with payment of $25.00 to the West Virginia Board of Registered Nurses at the specified address.

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