Registered Nurse Application Form

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Vancouver, BC
V6J 3Y8 Canada
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Registered Nurse
Application Form
NCLEX–RN Standard Setting Panel of Judges
The National Council of State Boards of Nursing (NCSBN) is recruiting registered nurses to sit on the Standard Setting
Panel of​Judges. The panel will meet in Chicago, Sept. 9–11, 2015. Please complete both pages of the form. The
application deadline is May 12, 2015.
Return your completed form to kivari@crnbc.ca or fax 604.738.2272.
A B O U T T H E N C L E X – R N STA N DA R D S E TT I N G PA N E L
The NCLEX-RN® Test Plan is evaluated on a three-year schedule involving an extensive job analysis survey of newly licensed nurses
and input from various nursing experts. The latest NCLEX-RN® Test Plan becomes effective April 1, 2016. Along with the test plan,
the passing standard is re-evaluated on a three-year cycle to ensure the appropriate passing standard is in place for the corresponding examination. NCSBN’s Board of Directors is responsible for setting the passing standard but the tasks performed during
the panel of judges meeting will help the Board of Directors when the standard setting decision is made.
The Standard Setting Panel of Judges will comprise a minimum of nine (9) members, representing various NCSBN regulatory bodies
using NCLEX for primary licensure purposes. The group will reflect registered nurses with varying years of nursing experience in
entry-level clinical practice areas.
Travel-related expenses will be covered by NCSBN​.
A P P L I C AT I O N
First name
Last name
Address
Registration ID
Email
TelephoneCell
Employer
Job title
Do you work with, supervise, and/or educate newly registered
RNs within their first 12 months of practice?
Yes
No
Do you work in clinical practice?
Have you been employed as an RN for at least two or more years?
Have you been employed less than one year as an RN?
Yes
No
Yes
Yes
No
No
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Please describe why you are a good candidate for the NCLEX-RN Standard Setting Panel of Judges. What
special skills and knowledge will you bring to the meeting?
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