CGFNS Application Instructions

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    Nurses who have earned the CG(Certification Program) certificconsistently have a higher rateof success on the NCLEX-RN examination than nurses whohave not earned certificates.

    CGFNS Internationals Certi ication Program (CP) isdesigned specifcally or frst-level, general (registered)nurses educated outside the United States who wishto practice nursing in the United States. In order to beeligible, you must have completed su cient classroominstruction and clinical practice inn Adult health (medical/surgical) nursingn Maternal/In ant nursing (obstetrics), excluding

    gynecologyn Nursing care o children (pediatrics) andn Psychiatric/Mental health nursing, excluding

    neurology

    I you have not completed a su icient number o hours in each o the above areas, you will not beapproved to take the CGFNS Quali ying Examuntil you complete them through a government-approved nursing school. You must also holdan initial license/registration as a irst-level,general nurse in your country o education,

    and currently hold a license/registration asa frst-level, general nurse.

    Revised February 2011. Copyright 2010 CGFNS International. All rights reserved.

    Certi cation Program Instructions

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    CGFNS contact in ormationCGFNS Customer Service* +1 (215) 349 8767Appointments* +1 (215) 222 8454Mailing address Suite 400, 3600 Market Street, Philadelphia, PA 19104-2651CGFNS Web site www.cg ns.orgCGFNS Connect https://www.cg ns.org/cerpassweb/intro.jspApply/Check Status https://www.cg ns.org/cerpassweb/intro.jspEmail https://www.cg ns.org/cerpassweb/processContactUs.do

    *check sidebar on https://www.cg ns.org/cerpassweb/processContactUs.do or times

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    Certifcation Program Instru

    Table o contentsWhat this booklet contains . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1

    Introduction to the Certifcation Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1

    Credentials review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2

    Are you a frst-level, general nurse? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2

    Do you meet the educational requirements? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2

    Do you have appropriate license/registration documents? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2

    English language profciency examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

    Who is not required to take the examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

    Who is required to take the examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

    Contacting the examining institutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

    Studying or the examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

    The CGFNS Quali ying Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

    Credentials review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4Preparing or the exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

    The O cial Study Guide for the CGFNS Qualifying Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

    Practice tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

    Question ormat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

    Exam dates and locations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

    Taking the CGFNS Quali ying Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

    Exam results and diagnostic profle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

    Earning the CGFNS (Certifcation Program) certifcate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

    Those who do not pass the examinations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

    Apply online . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

    Other CGFNS services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

    I your application expires . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

    Completing the orms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

    The Request for Validation of License/Registration/Certi cation orm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

    The Request for Academic Records/Transcripts orm. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

    The CGFNS Photo Identi cation Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

    The Authorization to Release Information orm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

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    Finishing your application . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

    Checklist to avoid processing delays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

    Falsifed or altered documents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

    Submitting your application . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

    Communicating with CGFNS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

    Your online account . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

    Email . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

    Correspondence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

    On-site appointments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

    Telephone calls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

    In the event o a disaster . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

    Authorization to Release In ormation orm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12

    Credit Card Payment Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

    2011 CGFNS International. All rights reserved. The in ormation in this handbook supersedes previously released handbooksand other documents and Web pages.

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    Certifcation Program Instructio1

    What this booklet contains

    1. The Certifcation Program processn A credentials review (page 2)n An English language profciency exam (page 3)n The CGFNS Quali ying Exam (page 4)n Exam results and diagnostic profle (page 6)n Applying online (page 6)

    2. Instructions or completingn th e Request for Validation of License/Registration/

    Certi cation orm (page 8)n the Request for Academic Records/Transcripts orm

    (page 8)n the CGFNS Photo Identi cation Form (page 9 )n the Authorization to Release Information orm (page 9)

    3. Guidelines or communicating with CGFNS (page 10)

    4. The Authorization to Release Information orm (page 12)

    5. The Credit Card Payment Form (page13)

    This instruction booklet describes how to apply or theCertifcation Program and earn a CGFNS (Certifcation Program)certifcate. There are many steps (see Table 1 on page 7). Pleaseread this entire booklet be ore completing any part o theapplication online.

    CGFNS processes all applications at its headquarters in

    Philadelphia, Pennsylvania, in the United States. I you have anyquestions or concerns as you proceed through the CertifcationProgram, please contact CGFNS Customer Service by themethods and during the hours shown on our Contact Us page athttps://www.cg ns.org/cerpassweb/processContactUs.do . Re eto page 10 or guidelines on communicating with CGFNS. Formore in or mation on CGF NS and its services, please visit ourWeb site at www.cg ns.org .

    Introduction to the Certifcation Program

    Every year, thousands o nurses rom around the world decidethat they would like to practice as registered nurses in theUnited States. The CGFNS Certifcation Program can help youwork toward your goal. The Certi ication Program is a three-part program designed specifcally or frst-level, general nurseseducated and licensed/registered outside the United Stateswho wish to practice nursing in the United States. Those who

    are success ul in the program are awarded a CGFNS (CertifcationProgram) certifcate, which is good or li e.

    A CGFNS (Certifcation Program) certifcate assists registerednurses in three ways:

    1. It helps to quali y or an occupational visa because it satisfesthe nursing examination requirement o Section 343 o theIllegal Immigration Re orm Immigrant Responsibility Act o 1996 and o the VisaScreen: Visa Credentials Assessmentprogram.

    2. It helps to meet licensure and NCLEX-RN examinationeligibility requirements in many U.S. states.

    3. It provides reasonable assurance o success on theNCLEX-RN examination, because the CGFNS Quali yingExam uses the same test blueprint as the NCLEX. Passingthe CGFNS Quali ying Exam does not guarantee that youwill pass the NCLEX-RN examination, but nurses whohave earned CGFNS (Certi ication Program) certi icatesconsistently have a higher rate o success on the NCLEXthan nurses who have not.

    The Certifcation Program includes:

    Part 1: Credentials reviewCGFNS certi ies that you are a irst-level, general nurse (asdefned historically by the International Council o Nurses) byevaluating your education and license/registration. Page 2 ormore in ormation.

    Part 2: English language profciency examinationAn English language pro iciency examination is taken todetermine your understanding o English, both written andverbal. Page 3 or more in ormation.

    Part 3: CGFNS Quali ying Exam The CGFNS Quali ying Exam is a one-day Internet-basedexamination o your nursing knowledge. Page 4 or morein ormation.

    You must success ully complete all three parts o the CertifcationProgram in order to earn the CGFNS (Certi ication Program)

    certifcate.

    https://www.cgfns.org/cerpassweb/processContactUs.dohttp://www.cgfns.org/http://www.cgfns.org/http://www.cgfns.org/https://www.cgfns.org/cerpassweb/processContactUs.do
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    2 Certifcation Program Instructions

    Credentials review

    In reviewing your eligibility or the CGFNS (Certi icationProgram) certi icate, CGFNS sta give personal attention toeach application. They make decisions based on the mostcurrent knowledge o nursing and license/registration aroundthe world. To ensure that all applicants are treated airly, CGFNSreserves the right to reevaluate any application at any point inthe process, especially i we receive additional in ormation abouta jurisdictions nursing education and registration requirements.

    When CGFNS sta review your documents to determine youreligibility or the Certifcation Program, they ask the ollowingquestions:

    Are you a frst-level, general nurse?You must be educated as a irst-level, general nurse and belicensed/registered in your country o education, as well as inthe country in which you hold a current license/registration as afrst-level, general nurse.n A irst-level, general nurse (as de ined historically by the

    International Council o Nurses) is called a registered or apro essional nurse in some countries.

    n A second-level nurse may be called an enrolled, vocational orpractical nurse or a nurse assistant. Second-level nurses arenot eligible to be licensed as registered nurses in the UnitedStates and, there ore, can not be approved to take the CGFNSQuali ying Exam.

    n A general nurse has studied theory and has had clinicalpractice in a variety o nursing areas. A nurse who specializedin one area without being educated and licensed/registeredas a general nurse ( or instance, midwi e, pediatric nurse or

    psychiatric nurse) will not be approved to take the CGFNSQuali ying Exam.

    Please note: Physicians and other health care pro essionals whohave not completed a curriculum in an approved nursing schoolare not eligible or the Certifcation Program.

    Do you meet the educational requirements?CGFNS requires documents that veri y that you have:n success ully completed a secondary school educationn graduated rom a government-approved, general nursing

    program o at least two years

    n received theory and clinical education in each o theollowing: nursing care o the adult (which includes medical

    and surgical nursing), maternal/in ant nursing, nursing careo children and psychiatric/mental health nursing I you graduated rom a government-approved, general

    nursing program, but have not had theory and clinicalpractice in one o the areas o nursing listed above,you still may be able to meet the CGFNS requirementby passing a nursing course in the missing area. Thecourse must be o ered by a government-approvedschool o nursing and must contain both theory andclinical practice in the same course. Non-academicwork experience and in-service education do not meetCGFNSs education requirement or eligibility.

    I you have not completed a secondary schooleducation, you can meet the CGFNS secondaryeducation requirement by obtaining a secondary schoolequivalency certifcate.

    Do you have appropriatelicense/registration documents?Your licensing/registration authorities must provide CGFNS withdocuments veri ying the ollowing:n initial registration as a frst-level, general (registered) nurse

    in the country where you completed your general nursingeducation and

    n current frst-level, general (registered) nurse registration

    I you have previously applied or CGFNS services, and therequest or validation o your license/registration is more thanthree years old, you will need to complete another Request forValidation of License/Registration/Certi cation online and send itto your licensing authorities.

    I CGFNS has questions about your documents, the respectivelicensing authority may be asked to respond or provideadditional documentation so that the review o your applicationcan continue. Further in ormation may be required a ter theinitial review.

    I your country does not issue a license/registration and yournursing diploma authorizes you to practice, you must still

    orward the Request for Validation of License/Registration/ Certification orm to the issuing authority and request theyvalidate your diploma to ensure there has been no revocation,suspension or restriction to practice.

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    Certifcation Program Instructio3

    English language profciency examination

    Applicants applying to the Certi ication Program must passan English language pro iciency examination. The ollowingexaminations have been approved to meet the requirement:n TOEFL PBT (Test o English as a Foreign Language Paper-

    based Test)n TOEFL iBT (Test o English as a Foreign Language Internet-

    based Test)n TOEIC (Test o English or International Communicators)n IELTS (International English Language Testing System)

    Academic Module

    Who is not required to take the examinationYou may be exempt rom the English language pro iciencyrequirement i you meet all o the ollowing criteria:n country o nursing education was Australia, Barbados, Canada

    (except Quebec: the only approved schools in Quebec areMcGill University and Dawson College in Montreal, Vanier

    College in St Laurent, John Abbott College in Sainte-Anne-de-Bellevue and Heritage College in Gatineau), Ireland,Jamaica, New Zealand, South A rica, Trinidad and Tobago,the United Kingdom or the United States and

    n the language o textbooks and verbal instruction o youreducation was English.

    Who is required to take the examinationApplicants not exempt rom the English language profciencyexamination must take and achieve a passing score on one o the ollowing English examinations:n TOEFL-PBT or TOEFL iBT ( Test o English as a Foreign

    Language paper-based test or Internet-based test),administered by the Educational Testing Service (ETS).Passing Score: 540 (paper-based version) or 207 (computerized version) or 83 (internet-based version). For registered nursesin the Certi ication Program, only a passing total score isrequired.

    n TOEIC(Test o English or International Communication),administered by ETS. Passing Score: 725.

    n IELTS (International English Language Testing System)Academic Module is jointly managed by British Council,IDP: IELTS Australia and the University o Cambridge ESOL

    Examinations. Passing Score: 6.5 Overall.

    The U.S. Citizenship and Immigration Services (USCIS) do notallow the combining o scores rom di erent testing services.

    It is important that you request that your English languagepro iciency scores are made available to CGFNS. All Englishlanguage profciency scores are valid or two years rom date o exam administration. You must pass both the CGFNS Quali ying

    Exam and the required English language pro iciency examswithin two years o each other, in any order.

    All exam scores must be provided directly by the examininginstitution to CGFNS. CGFNS will not accept scores orwardedby you or anyone else. With the exception o IELTS and TOEIC,scores are not accepted by mail.

    I you took the ETS or IELTS tests in the last two years, or haveapplied to take these tests, please provide CGFNS with the examdate, and your test ETS registration number or IELTS test report

    orm number as soon as possible. For TOEFL PBT or TOEFL iBTplease re erence code number 9988 on your application ormto ensure that your TOEFL results will be sent electronically toCGFNS. For IELTS, please request that your exam scores are madeelectronically available to CGFNS. For TOEIC, please request thatyour scores be mailed to CGFNS.

    Contacting the examining institutionsCGFNS does not make appointments or you to take the Englishlanguage profciency examinations. Please contact ETS or IELTSdirectly to make arrangements to take the examination o yourchoice. For contact in ormation regarding the English exams, goto www.cg ns.org/sections/programs/cp/cp-english.shtml

    Studying or the examination To help you become amiliar with the types o questions on theEnglish language profciency exam, CGFNS has included Englishlanguage practice questions in The O cial Study Guide for theCGFNS Qualifying Exam. English study documents also maybe obtained directly rom the testing service addresses listedpreviously. You may also purchase English language practiceaudio CDs rom CGFNS through your online account at h ttps://www.cg ns.org/cerpassweb/login.jsp .

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    4 Certifcation Program Instructions

    Credentials reviewYou will undergo a credentials review to determine youreligibility or the CGFNS Quali ying Exam. There ore, send allo your documents to CGFNS as early as possible prior to thedeadline date or the desired exam.

    I , a ter review o your credentials, we do not approve you or the

    CGFNS Quali ying Exam, you will receive an explanation letter.It is not unusual to ail to be approved or the exam becauseo a defciency in your education. In many cases, with urthereducation, applicants can become approved or the exam.

    Preparing or the exam The best way to prepare or the CGFNS Quali ying Exam isto review what you learned in your basic nursing educationprogram. Study these areas: adult (medical and surgical)nursing, Maternal/In ant nursing, nursing care o children andpsychiatric/mental health nursing. You also can beneft romreviewing the nursing process and patient needs as they aretaught in the United States (see below or in ormation on theO cial Study Guide for the CGFNS Qualifying Exam to help youprepare or the exam).

    Please note: Other than the CGFNS materials listed in thisbooklet, CGFNS does not operate, license, endorse orrecommend any outside training, review, online courses, schoolsor study materials that claim to prepare applicants or the CGFNSQuali ying Exam.

    The Ofcial Study Guideor the CGFNS Quali ying Exam

    CGFNS has developed a study guide to help you identi y yourstrengths and weaknesses in nursing knowledge. This studyguide is not a substitute or basic education or an in-depthreview o nursing textbooks. Using it does not guarantee apassing result on the CGFNS Quali ying Exam. The samplequestions used in this guide were once actual exam questions,but will not appear on the exam you will be taking.

    The O cial Study Guide for the CGFNS Qualifying Exam includes:n sample nursing questions with explanations o the answersn complete examples o the CGFNS Quali ying Exam

    with sample answers and explanations or correct and

    incorrect answersn a chapter on how to understand multiple-choice questionsn a reading list or all areas o nursing in the exam, andn a description o the way nursing is practiced in the United

    States.

    The study guide will automatically be sent to you when wereceive your application and ull payment.

    Practice testsCGFNS o ers practice tests on each o the our major areaso nursing in the United States. The practice tests contain 50questions related to the subject, and o er explanations o thecorrect and incorrect answers as well as a diagnostic profle. Thepractice tests are as ollows:n Adult Health Nursing contains exam questions that ocus on

    the adult patient with acute or chronic illness in any healthcare setting.

    n Nursing Care o Children contains exam questions thatocus on preventing illnesses in and injuries to children and

    on the care o sick children.n Maternal/In ant Nursing contains exam questions that

    ocus on the care o childbearing women and their amiliesthroughout all stages o pregnancy and childbirth, as well asthe frst our weeks ollowing birth.

    n Psychiatric/Mental Health Nursing contains exam questionsthat ocus on the relationships and communication betweenpeople as they relate to healthy behavior (mental health) andon psychiatric illnesses.

    These practice tests may be ordered rom your online accountat https://www.cg ns.org/cerpassweb/login.jsp /.

    Question ormatMultiple-choice questions The CGFNS Quali ying Exam is primarily a multiple-choice

    examination. This means choosing a correct answer rom severalchoices (see Figure 1). The multiple-choice questions generallydescribe a patient, the symptoms, the treatments or the nursingcare the patient will receive. This description contains all thein ormation you need to choose the correct answer.

    Figure 1: An example o a multiple-choice nursing questionsuch as those ound on the CGFNS Quali ying Exam.

    Standard multiple-choice questionWhich instructions should the nurse provide when teaching apatient who was recently diagnosed with type 2 diabetes?

    Possible answersA. Eat most meals at home.B. Eliminate desserts except ruit.C. Be aware o the availability o special diabetic oods.D. Maintain a regular meal schedule.

    The CGFNS Quali ying Exam

    https://www.cgfnsstore.org/https://www.cgfnsstore.org/
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    Alternate item type questions The CGFNS Quali ying Exam also contains several alternate itemtypes questions that are di erent rom the single-answer,multiple-choice ormat. Alternate item types include:n multiple response questions that ask you to select more than

    one correct answern hot spot questions that ask you to identi y an area on a picture

    or graph

    n ll in the blank questions that ask you to type in numericalanswers to calculation questions and

    n drag and drop questions that ask you to order items by rank

    Exam dates and locationsOnce you complete the credentials review and are approvedto take the CGFNS Quali ying Exam, you will receive an Authorization to Test notifcation that contains instructions onhow to schedule your examination. You will be given two testwindows o fve days each rom which to choose a date and time

    or your examination.

    On the day o the exam, you simply go to the location youscheduled at the appointed time. You will be asked to presentat least two orms o identi ication, one being a photo ID.Acceptable photo IDs are passports or o icial government-issued identifcation.

    Changing your exam date a ter you receive approvalI you need to change your exam date, you may do so by giving72 hours notice be ore your scheduled exam:n to another day or time in the fve-day test window o your

    originally scheduled exam, without chargen

    to the later fve-day test window you were given, withoutcharge

    Taking the CGFNS Quali ying Exam The CGFNS Quali ying Exam takes approximately three hours tocomplete. Please plan your travel accordingly. I you need a visato travel to the exam center, apply to the proper authority earlyenough to have your papers be ore your departure or the exam.

    At the exam centerPlease plan to arrive at the exam center at least 15 minutes priorto your scheduled exam. I you are late, you will not be admitted

    to the exam.Family and riends are not permitted in the exam center, norare books, papers, cameras, calculators, tape recorders, mobilephones or pagers. Please do not bring valuable items or largeamounts o money to the exam center. Eating or drinking willnot be allowed while the exam is in session.

    When you arrive, exam center sta will ask you to sign in.Bring two orms o identi ication, one o which is a passportor o cial government-issued identifcation that includes yourphotograph.

    In the exam room, please ollow exactly the instructions thatare given to you. Rules regarding seating and behavior duringthe exam must be ollowed. For example, you will be assignedto a testing station that you may not change, a sta member

    must accompany you i you leave the room and you may not talk during the exam. No exceptions to the rules will be made. Examcenter sta will observe test takers during the exam to makecertain instructions are ollowed.

    Only applicants who are o icially scheduled by CGFNS areauthorized to take the exam. Scores obtained and examssubmitted by unscheduled applicants are invalid.

    Inappropriate activitiesBecause the CGFNS Quali ying Exam is designed to measureyour nursing knowledge, no one may give or receive help duringthe exam. Inappropriate help includes getting assistance rom

    anyone other than exam center sta , helping another test taker,re erring to any printed material that could assist you on theexam. Anyone who gives or receives such help will be asked toleave the exam center and their exam will not be scored. Theevent will be reported to CGFNS, and the person may be barred

    rom taking the CGFNS Quali ying Exam in the uture.

    The attestation section on the application orm in this handbook indicates that you should not engage in any activity that couldbe interpreted as alsi ying, tampering with or altering the exam.You should re use any requests by third parties, eg, riends,recruiters or employers to memorize questions or give them

    details regarding the content o the tests. Such activities willresult in your test being or eited and may prevent you rombeing eligible or all uture exams.

    I you see anyone not ollowing the rules and instructions, or i you observe a disturbance o any kind during the exam, pleasereport this to the exam center supervisor at the time it occurs orbe ore you leave the premises. You may also communicate yourexperience by writing to the ollowing address:

    CGFNS Test Administration Department3600 Market Street, Suite 400Philadelphia, PA 19104-2651 USA

    All allegations related to inappropriate activities are takenseriously by CGFNS and will be investigated to ensure theintegrity o the exam.

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    6 Certifcation Program Instructions

    Exam results and diagnostic profleApproximately two weeks a ter the ive-day test window inwhich you took your exam, you may access your results in theonline account at https://www.cg ns.org/cerpassweb/login.jspthat you created when you applied or the Certifcation Program.

    The results will include a diagnostic pro ile with an analysisand description o our subject areas, designated Client Needcategories:n Sa e, e ective care environmentn Health promotion and maintenancen Psychosocial integrity andn Physiological integrity

    Since these our categories orm the basis not only o the CGFNSQuali ying Exam, but also o the NCLEX-RN examination,

    knowledge o your per ormance in these areas will help toprepare you.

    Earning the CGFNS(Certifcation Program) certifcateWhen you success ully complete the credentials review and passboth the CGFNS Quali ying Exam and the English languageprofciency exam within two years o each other, you will receiveyour CGFNS (Certifcation Program) certifcate.

    Those who do not pass the examinationsI you ail either the CGFNS Quali ying Exam or the Englishlanguage profciency exam you will not be awarded a CGFNS(Certi ication Program) certi icate. You will need to apply toretake each o the exams you have ailed. Remember thatboth the CGFNS Quali ying Exam and the English languageprofciency exam must be passed within two years o each other.

    Apply online

    Only online applications will be accepted or the CertifcationProgram. You may apply online at https://www.cg ns.org/cerpassweb/intro.jsp . You may still need to mail certaindocuments (e.g., copies o secondary school education

    documents). You must provide an email address in yourapplication because all correspondence rom CGFNS will beelectronic. You will receive your certifcate by mail.

    https://www.cgfns.org/cerpassweb/intro.jsphttps://www.cgfns.org/cerpassweb/intro.jsphttps://www.cgfns.org/cerpassweb/intro.jsphttps://www.cgfns.org/cerpassweb/intro.jsp
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    Table 1: Overview o the process or the Certifcation Program

    ACTIONS YO TA E ACTIONS CGFNS TA ES

    Register to create your online account. Go to https://www.cg ns.org/cerpassweb/register.jsp, and fll out the in ormation felds. This accountwill help keep you in ormed about the status o your application, andhelp us in orm you about documents we need rom you, even i youchoose to apply through postal mail rather than online.

    Apply online a ter creating your user account. CGFNS sends you welcome notifcation and, a ter we receive your

    payment, your CGFNS ID number* electronically. We also send TheO cial Study Guide for the CGFNS Qualifying Exam in PDF ormat.

    Prepare and send the Request for Validation of License/Registration/ Certi cation orm to each licensing authority who has issued youa license/registration, including rom the country where you wereeducated, requesting that they complete the orm and directly send it toCGFNS with validation**

    A ter receiving all required documents rom you, your schools and yourlicensing authorities, CGFNS reviews them. We will noti y you i requireddocuments or your application are missing. You can check your onlineaccount at https://www.cg ns.org/cerpassweb/login.jsp to view thestatus o your application.

    When you success ully complete the credentials review, we send you an Authorization to Test notifcation that includes scheduling instructionsand the dates o the two test windows or which you are authorized totake the CGFNS Quali ying Exam.

    Prepare and send the Request for Academic Records/Transcripts orm toyour schools, asking them to complete the orm and send your records**directly to us.

    Schedule a date and time and select an exam center or your examination

    ollowing the instructions in your Authorization to Test notifcation

    Take the CGFNS Quali ying Exam. We noti y you o the results.

    I you passed, move on to the next step. I you did not pass or missedyour exam, login and order a CGFNS Qualifying Exam Re-examination application at https://www.cg ns.org/cerpassweb/login.jsp

    Register with the examining institution and take the English languageprofciency exam. Request exam scores be orwarded or made availableelectronically to CGFNS.

    CGFNS reviews the results or passing score. I you passed, move on tothe next step. I you did not pass, register and take the exam again.

    You, your schools and your licensing authorities have responded toany correspondence rom CGFNS regarding missing in ormation ordocuments. You passed both exams within two years o each other and

    success ully completed the credentials review.

    We send you your CGFNS (Certifcation Program) certifcate.

    *Please note: I you applied or another CGFNS service in the past, the CGFNS ID number you were issued at that time remains your permanent ID number.

    **IMPORTANT:Documents that must come directly rom your schools o cials, licensing authorities or other source agencies can be translated by them and sentdirectly to CGFNS in the signed, stamped and sealed envelope. Documents that you are permitted to send (such as marriage certifcates, secondary school diplo-mas) can be translated by you or anyone you choose. These translations must contain the ollowing, called the Certifcate o Accuracy, typed or written at the endo the translation. The translator must sign the translation.

    Certifcate o AccuracyThis is to certi y that this is a true and correct English translation o the attached photocopy o the original [insert name o document] o [insert applicantname]

    CGFNS can also provide translations or the ee listed at www.cg ns.org/sections/apply/ ees.shtml#5 .

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    8 Certifcation Program Instructions

    Other CGFNS servicesn Document translation This is to request that CGFNS translate

    your required documents into English.n Replacement certi cate This is a request to replace a missing

    original CGFNS (Certifcation Program) certifcaten Veri cation of certi cate letter This is a request to veri y that

    a CGFNS (Certifcation Program) certifcate was issued

    n Forwarding academic records/transcripts This is a requestor CGFNS to send copies o your o cial academic records/

    transcripts to a licensing board or educational institution (thisservice does NOT include an evaluation o the documents).

    n Forwarding academic records/transcripts and license/ registration/certi cation This is a request or CGFNS to sendcopies o both your o cial academic records/transcripts andyour o cial pro essional license/registration validations ordiploma (i it gives authorization to practice) to a licensingboard or educational institution (this service does NOTinclude an evaluation o the documents).

    Fees or other CGFNS services can be ound at www.cg ns.org/sections/apply/ ees.shtml

    I your application expires

    You will be given 12 months to meet the credentials evaluationrequirements o the Certifcation Program. I your applicationexpires, you can apply or the Certification Program: Reprocessan Expired Initial Order and pay the ee. Reprocess applications

    remain open or 12 months starting rom the date the orderis placed. Reprocess applications cannot be placed until theprevious order expires.

    Completing the orms

    The Request or Validation o License/Registration/Certi cation ormCGFNS needs validations o your current and your very irstlicense/registration obtained outside the United States. Todo this, use the Request for Validation of License/Registration/ Certi cation included on page 12 in this booklet. Complete therequested in ormation in the applicants section at the top o

    the orm and send it to each licensing authority that issuedyour license/registration. The section at the bottom titled FORLICENSING AUTHORITY TO COMPLETE is to be completed bythem. I you have a diploma that authorized you to practice inyour country, send this orm to the institution that issued yourdiploma ( or example, your school or the Ministry o Health)and request that an o cial copy o the diploma in the originallanguage be sent to CGFNS. I we receive documents that arenot in English and without an English translation attached, wecan have them translated or the ee listed at www.cg ns.org/sections/apply/ ees.shtml .

    Please note: I validation o your non-U.S. license/registrationwas previously mailed to us three or more years ago, it needs tobe validated again. Further in ormation may be required a teryour license/registration orms or diplomas are reviewed.

    It is a good idea to track the orms by contacting each authoritywithin a reasonable time a ter you send the orms to them.

    The Request or Academic Records/Transcripts orm To supply us with the necessary in ormation about youreducation, you will need to send one copy o the Request for Academic Records/Transcripts orm (page 13) to each healthcare post-secondary (tertiary) school that you attended outsidethe United States and request they send your academicrecords/transcripts directly to CGFNS. Complete the requested

    in ormation in the applicants section be ore sending it to eachschool that you attended.

    Request that each school complete the bottom portion o theorm entitled FOR SCHOOL TO COMPLETE. The school needs

    to then enclose your academic records/transcripts and sendthem directly to CGFNS. CGFNS will not process the orms unlessreceived directly rom the school.

    It is a good idea to track the orms by contacting each schoolwithin a reasonable time a ter you send the orms to them.

    I your academic records/transcripts are not in English, you must

    have the school provide a certifed translation. CGFNS is able toprovide translation or a ee ( see www.cg ns.org/sections/apply/

    ees.shtml ).

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    Important noteI you receive these orms rom the issuing authorities and

    orward them to CGFNS, they will not be accepted, even i unopened. We need to receive them directly, sealed, unopenedand un orwarded.

    Incomplete orms will result in application processing delays.

    The CGFNS Photo Identi cation Form

    One page 15 is the CGFNS Photo Identification Form. We usethis photo or your certifcate. Please print or type all requestedin ormation and, according to the instructions at the top,securely a x a passport-size photograph to it. The photographmust be current, legible and signed on the ront . Please submitthis orm by postal mail.

    The Authorization to Release In ormation ormBecause CGFNS protects your privacy, your application will onlybe discussed with you. I you choose to let CGFNS disclose flein ormation or provide fle status in ormation to another person,you need to submit an Authorization to Release Information orm,

    to designate an authorized agent. Or, i you choose to have

    all correspondence rom CGFNS sent to someone else, youcan do this by either completing the Authorization to ReleaseInformation orm or providing the other persons mailing andemail addresses on your application orm.

    The Authorization to Release Information is valid or two years.You can revoke the authorization at any time. CGFNS mustreceive a revocation in writing by postal mail or courier service.

    The completed Authorization to Release Information orm may besubmitted to CGFNS with your application or mailed separatelyby postal mail or delivered by courier.

    This orm is available on the Web site at www.cg ns.org/sections/apply/ orms.shtml and page 16 o this booklet.

    Please note: CGFNS maintains only one email and mailingaddress per applicant. There ore, i you choose to have yourcorrespondence rom CGFNS sent to an alternative address,correspondence meant or you, including your certi icate,will be sent there. CGFNS cannot be held responsible or anycorrespondence withheld by a third party you designated as an

    authorized agent.

    Finishing your application

    Checklist to avoid processing delays

    Be ore submitting your application, check to see that you have:

    completed each item on the application.

    included an email address or correspondence.

    sent by mail legible photocopies o your secondary school education or external exam certifcate, with literal Englishtranslation, including a Certi cate of Accuracy at the end o the translation (page 7).

    sent the completed Request for Validation of License/Registration/Certi cation orm to each licensing agency where you haveever held a license/registration in your feld or, in cases where your diploma authorizes legal practice, this same orm mailedto CGFNS rom the school that issued your diploma (page 8).

    sent the completed Request for Academic Records/Transcripts orm to each post-secondary (tertiary) schools (page 8).

    sent the signed CGFNS Photo Identi cation Form with your photo signed and attached (page 9).

    sent the signed Authorization to Release Information orm, i you would like CGFNS to communicate with someone otherthan yoursel (pages 9 and 12).

    included ull payment through a bank check , an international money order (drawn on a United States bank in UnitedStates dollars) made payable to CGFNS, or credit card payment (Visa, MasterCard or Discover), with the completed Credit Card Payment form (page 13). DO NOT SEND CASH.

    MUST BE SUBMITTED DIRECTLY TO CGFNS FROM OTHER AUTHORITIES:

    English language profciency scores rom ETS or IELTS, i required (page 3).

    Completed Request for Validation of License/Registration/Certi cation orms and corresponding documents directly sentrom all licensing authorities (page 8).

    Completed Request for Academic Records/Transcripts orms and corresponding records rom each post-secondary healthcare school you attended (page 8).

    Certifed translation o any documents not in English.

    http://www.cgfns.org/sections/apply/forms.shtmlhttp://www.cgfns.org/sections/apply/forms.shtmlhttp://www.cgfns.org/sections/apply/forms.shtmlhttp://www.cgfns.org/sections/apply/forms.shtml
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    10 Certifcation Program Instructions

    Communicating with CGFNS

    Please note: CGFNS does not return any o the documents thatare part o your application. Please send only photocopies, notoriginals, o the documents CGFNS requests directly rom you.

    Falsifed or altered documentsI CGFNS fnds that your documents have been altered in anyway, or in ormation contained in your application is alsifed, youwill not be permitted to take the CGFNS Quali ying Exam. I yourdocuments have been altered in any way or in ormation in yourapplication is alsifed, your application will not be accepted, yourfle will be sealed, you will lose your entire application ee andyou will not be eligible or other CGFNS services in uture. Thisincludes all documents and application orms submitted by you,or on your behal by another person. There ore, be ore anything

    is sent to CGFNS, make certain that none o the documents andorms have been alsifed or altered in any way.

    Submitting your applicationA ter completing any orms other than the ones to be sent toissuing authorities, send them to CGFNS International, alongwith a photocopy o your secondary school diploma or externalexam certi icate, the CGFNS Photo Identification Form, yourpassport-size photos and all required ees, to the ollowingaddress:CGFNS International3600 Market Street, Suite 400Philadelphia, PA 19104-2651 USA

    Your online accountYou can apply or any o CGFNSs services online at https://www.cg ns.org/cerpassweb/intro.jsp . By creating an account you can

    check your fle status, veri y receipt o documents and scores,make changes to your contact in ormation, con irm mailingdates and access many other services all through your browser.

    I you have questions about your application or requireddocuments, we recommend that you check the status o youronline account at https://www.cg ns.org/cerpassweb/login.jsp .You may also contact CGFNS via letter, telephone or throughthe Contact Us orm at https://www.cg ns.org/cerpassweb/processContactUs.do . The ollowing guidelines are providedto make this communication easier (see Table 2 on page 11 oradditional in ormation).

    EmailYou may contact CGFNS Customer Service with questionsregarding your application by email through the Contact Us

    orm on our Web site at https://www.cg ns.org/cerpassweb/processContactUs.do

    CorrespondenceCGFNS policy is that your application is con idential, to bediscussed only with you. All correspondence must include yourCGFNS ID number, ull name, and birth date.

    On-site appointmentsYou or your authorized agent may call +1 (215) 222 8454 toschedule a 30-minute appointment in our CGFNS o ice inPhiladelphia, Pennsylvania, to discuss your fle.

    Telephone callsCGFNS Customer Service can provide your status in ormationby telephone. We will not release in ormation by phone to

    anyone other than you unless we receive a completed andsigned Authorization to Release Information orm. I you wish totelephone us, call Customer Service at +1 (215) 349 8767. To savetime, have your CGFNS ID number ready. I the Customer Servicerepresentative is unable to adequately veri y your identity,in ormation will not be released by telephone.

    For Customer Service hours, go to the Contact Us orm at https://www.cg ns.org/cerpassweb/processContactUs.do . CGFNS inot available weekends or U.S. holidays, and we do not acceptreverse charge telephone calls.

    In the event o a disasterCGFNS makes every e ort to ensure that our communicationwith you is straight orward and timely. However, some eventsare out o our control. Events such as natural disasters, politicalunrest and postal strikes may occasionally occur. CGFNS cannotbe responsible or delays caused by such conditions, but we willmake every reasonable e ort to noti y you when this happens.

    Please note: Please keep CGFNS up-to-date with any changesin your contact in ormation, especially in the a termath o adisaster in your country.

    https://www.cgfns.org/cerpassweb/processContactUs.dohttps://www.cgfns.org/cerpassweb/processContactUs.dohttps://www.cgfns.org/cerpassweb/processContactUs.dohttps://www.cgfns.org/cerpassweb/processContactUs.do
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    Certifcation Program Instructions11

    Table 2: Communication guidelines

    RE S NS F R C NIC I NW C NINI I E REq ES ? C NIC I N C NNELS SPECI L IPS

    You want to confrm that yourapplication documents havebeen received by CGFNS orthat you have been scheduled

    or an exam

    Only you oryour authorizedagent

    Telephone or check your status at https://www.cg ns.org/cerpassweb/intro.jsp or email CGFNSthrough the Contact Us orm at https://www.cg ns.org/cerpassweb/processContactUs.do

    Include your ull name, CGFNS IDnumber and birth date

    You have a question abouta letter that you received

    rom CGFNS

    Only you oryour authorizedagent

    Telephone, make an o ce appointment or emailCGFNS through the Contact Us orm at https://www.cg ns.org/cerpassweb/processContactUs.do

    Include your ull name, CGFNS IDnumber and birth date

    You need to noti y CGFNSo your address change

    Only you oryour authorizedagent

    Make the changes in your online account at https://www.cg ns.org/cerpassweb/login.jsp or e mailthrough the Contact Us orm at https://www.cg ns.org/cerpassweb/processContactUs.do

    Include your ull name, CGFNS IDnumber and birth date

    You want to order a study aidor other item

    Anyone Order through your online account at https://www.cg ns.org/cerpassweb/login.jsp

    Enter the name and address ordelivery o the study aids and pay theappropriate ee

    You want CGFNS tosend verifcation o yourcertifcate status

    Only you Place an order through your online account athttps://www.cg ns.org/cerpassweb/login.jsp or maila written request

    State the request and to whom the lettershould be sent. Include your CGFNS IDnumber, birth date, signature, and paythe appropriate ee at https://www.cg ns.org/cerpassweb/intro.jsp

    You want CGFNS to maila copy o your nursingeducation in ormation toa school or U.S. board o nursing

    Only you Place an order through your online account athttps://www.cg ns.org/cerpassweb/login.jsp or maila written request

    State the recipient o your educationin ormation. Include your CGFNS IDnumber, birth date and proo o namechange (i applicable), sign and mail theappropriate ee or pay online at https://www.cg ns.org/cerpassweb/intro.jsp

    You want to scheduleor change your CGFNSQuali ying Exam dateor location

    Only you Follow instructions within your Authorization to Test notifcation

    You wish to report a legalname change

    Only you Write to CGFNS including name changedocumentation at Suite 400, 3600 Market Street,Philadelphia, PA 19104-2651 USA

    Request should include signature,CGFNS ID number and birth date

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    12 Certifcation Program Instructions

    Authorization to Release In ormation

    NOTICE:By signing below you (1) allow CGFNS to disclose confdential, personal, private in ormation about you and your fleat CGFNS to the person designated below; (2) give up the right to receive in ormation rom CGFNS directly; and (3) release andindemni y CGFNS, its members, trustees, o cers and employees rom any liability or losses, damages or claims o any type arisingout o actions taken by CGFNS in reliance upon this Authorization to Release Information , herea ter known as Authorization.

    This Authorization will remain valid or two years rom the date supplied by you on the Date line below (or i no date is supplied,rom the date this Authorization is received by CGFNS).

    REVOCATION:This Authorization can be revoked by submitting a new authorization dated and signed a ter the initial authorization.In addition, you may revoke this Authorization in writing at any time, which will be e ective on or a ter the 30th day a ter CGFNSreceives it, by regular mail or courier, at its headquarters o ce in Philadelphia, Pennsylvania, USA.

    A THORIZATION:I authorize CGFNS to release to the authorized agent indicated by me below, any and all in ormation about meand my application/order or services rom CGFNS, including, and without limitation, the status o my application/order, the resultso any credentials review, examination or test and any other in ormation in or relating to my fle at CGFNS. I understand that all mail(including certifcates, exam scores and reports) will be sent to the authorized agent.

    This authorization revokes all previous authorizations submitted by the applicant.

    Your CGFNS ID number (i known) Your birth date (spell the month and enter numbers or the day and year)Month Day Year

    1 2

    Your signature

    Your signature Date / /Do not print Month Day Year

    Print your name

    3

    Your authorized agent (please print)

    Your contacts name

    The organization your contact is representing

    Your contacts address

    Day telephone Fax

    Evening telephone Email

    4

    3600 Market Street, Suite 400, Philadelphia, PA 19104-2651 USA +1 (215) 222 8454 www.cg ns.org

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    Certifcation Program Instructions13

    Cardholder in ormationCardholder name (as it appears on card)

    Applicant birth date (spell the month and enter numbers or the day and year)Month Day Year

    3600 Market Street, Suite 400, Philadelphia, PA 19104-2651 USA +1 (215) 222 8454 www.cg ns.org

    I NTERNATIONAL C OMMISSION onH EALTHCARE P ROFESSIONS

    A division of CGFNS International

    C OMMISSION on G RADUATES ofF OREIGN N URSING S CHOOLS

    A division of CGFNS International

    Please type or print legibly. To pay by credit card, please fll in below your name as it appears in your application/order and yourCGFNS ID number (i known). Complete the cardholder in ormation as requested.

    Applicant name1

    First (given) and middle names (leave a space between names)

    Last ( amily/surname) name(s) (leave a space between names)

    CGFNS Applicant ID number (i known)2 3

    4

    First name, middle initial and last name (Leave a space between names)

    Credit card number CVV2 number* (see below or explanation)

    Expiration date Month Year Total charges US $ (see ees page online at http://www.cg ns.org/sections/apply/ ees.shtml )

    *Explanation o credit card CVV2 number

    Visa and MasterCard: This number is printed in the signature area on the back o the card (they arethe last 3 digits a ter the credit card number).

    Credit card type (check one) n Visa n Mastercard n Discover

    Cardholder address ( or processing credit card payments only)

    Street

    Street

    City State/Province

    Post/Zip code Country

    Cardholder signature (authorization or payment)I hereby authorize a charge to my credit card or the total o all services ordered in this applicationincluding any ee adjustments in e ect as o the date the order is received.

    Signature o authorized cardholder

    5

    Credit Card Payment Form

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  • 8/6/2019 CGFNS Application Instructions

    18/18

    CGFNS ission To serve the global community through programs and services that veri y and promote

    the knowledge-based practice competency o health care pro essionals.

    3600 Market Street Suite 400 Philadelphia PA 19104-2651 USA +1 (215) 222 8454 www cg ns org

    http://www.cgfns.org/http://www.cgfns.org/