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Rule 1: Logic dictates that these forms should be applied only to the new in-coming Nursing students using these forms onwards until their graduation and
until new issuances are released by the Board of Nursing;

Rule 2: All those filing applications for this June 2009 Nurse Licensure Examinations and the succeeding NLEs ³prior to the effectively of these NEW FORMS´
should all be accepted by the Central and Regional PRC Offices without any condition. If there are any noted discrepancies or any untoward
observations, the Board of Nursing requires appropriate documentation and reporting from the respective PRC Offices and should be received by the
Board of Nursing until after the last day of the NLE. Everything should be directed as official communications to the Board of Nursing;
Rule 3: |  
, graduates c c cc for any discrepancies and therefore all applications duly submitted ³on time´ MUST
BE ACCEPTED. The Board of Nursing shall take necessary actions based on official reports received by the same at the Central Office within the
prescribed period as set in Rule 2;

As a general rule the Board of Nursing subscribes to the principle of K 


The college and its administration directly involved in the care and supervision
of students/graduates are and shall be responsible and accountable to the lawful authorities.

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PRC I.D No. 0463446 Valid Until: December 10, 2011
PNA No. 2011-038035 Valid Until: October 31, 2011
Date document is signed: Time:
Highest Nursing Degree Earned: Master of Arts in Nursing

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PRC I.D. No: 0211191 Valid Until: April 4, 2012
PNA No: 2011-038109 Valid Until: October 31, 2011
ADPCN No: 19519 Valid Until: May 31, 2011
Date document is signed: Time:
Highest Nursing Degree Earned: Master of Arts in Nursing

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Easter School Rd. Guisad, Baguio City : cc
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Tel.Fax: (074)424-6764/424-5483,
eastercollege@yahoo.com/www.eastercollege.ph.

  
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Hospital, Municipality/ City/ Province
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PRC I.D No. 0463446 Valid Until: December 10, 2011 PRC I.D No. Valid Until:
PNA No. 2011-038035 Valid Until: October 31, 2011 PNA No. Valid Until:
Date document is signed: Time: Date document is signed: Time:
Highest Nursing Degree Earned: Master of Arts in Nursing Highest Nursing Degree Earned:

44 57c/+c cccccc  "cc#.8#cc c c c c


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PRC I.D. No: 0211191 Valid Until: April 4, 2012
PNA No: 2011-038109 Valid Until: October 31, 2011
ADPCN No: 19519 Valid Until: May 31, 2011
Date document is signed: Time:
Highest Nursing Degree Earned: Master of Arts in Nursing

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Easter School Rd. Guisad, Baguio City " cc
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Tel.Fax: (074)424-6764/424-5483,
eastercollege@yahoo.com/www.eastercollege.ph.

  
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PRC I.D No. 0463446 Valid Until: December 10, 2011 PRC I.D No. Valid Until:
PNA No. 2011-038035 Valid Until: October 31, 2011 PNA No. Valid Until:
Date document is signed: Time: Date document is signed: Time:
Highest Nursing Degree Earned: Master of Arts in Nursing Highest Nursing Degree Earned:

44 57c/+c cccccc  "cc#.8#cc c c c c


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PRC I.D. No: 0211191 Valid Until: April 4, 2012
PNA No: 2011-038109 Valid Until: October 31, 2011
ADPCN No: 19519 Valid Until: May 31, 2011
Date document is signed: Time:
Highest Nursing Degree Earned: Master of Arts in Nursing
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Easter School Rd. Guisad, Baguio City c
Tel.Fax: (074)424-6764/424-5483,
eastercollege@yahoo.com/www.eastercollege.ph.


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Hospital/Home/Lying-in Clinic, Municipality/ City/ Province
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Lying-in Clinics/ Homes

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PRC I.D No. 0463446 Valid Until: December 10, 2011 PRC I.D No. Valid Until:
PNA No. 2011-038035 Valid Until: October 31, 2011 PNA No. Valid Until:
Date document is signed: Time: Date document is signed: Time:
Highest Nursing Degree Earned: Master of Arts in Nursing Highest Nursing Degree Earned:

44 57c/+c cccccc  "cc#.8#cc c c c c


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PRC I.D. No: 0211191 Valid Until: April 4, 2012
PNA No: 2011-038109 Valid Until: October 31, 2011
ADPCN No: 19519 Valid Until: May 31, 2011
Date document is signed: Time:
Highest Nursing Degree Earned: Master of Arts in Nursing

c For deliveries performed in Lying-In and Homes, ONLY THE CLINICAL


INSTRUCTOR AND CLINICAL COORDINATOR are REQUIRED TO SIGN

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Easter School Rd. Guisad, Baguio City
Tel.Fax: (074)424-6764/424-5483,
eastercollege@yahoo.com/www.eastercollege.ph.

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Hospital/Home/Lying-in Clinic, Municipality/ City/ Province
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Lying-in Clinics/ Homes

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PRC I.D No. 0463446 Valid Until: December 10, 2011 PRC I.D No. Valid Until:
PNA No. 2011-038035 Valid Until: October 31, 2011 PNA No. Valid Until:
Date document is signed: Time: Date document is signed: Time:
Highest Nursing Degree Earned: Master of Arts in Nursing Highest Nursing Degree Earned:

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PRC I.D. No: 0211191 Valid Until: April 4, 2012
PNA No: 2011-038109 Valid Until: October 31, 2011
ADPCN No: 19519 Valid Until: May 31, 2011
Date document is signed: Time:
Highest Nursing Degree Earned: Master of Arts in Nursing

For deliveries performed in Lying-In and Homes, ONLY THE CLINICAL


INSTRUCTOR AND CLINICAL COORDINATOR are REQUIRED TO SIGN
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Easter School Rd. Guisad, Baguio City A cccccccccccccccccc
Tel.Fax: (074)424-6764/424-5483,
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eastercollege@yahoo.com/www.eastercollege.ph.

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Hospital/Home/Lying-in Clinic, Municipality/ City/ Province
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(Indicate where case was performed,
(Not applicable for Birthing/ (Name and Signature)
e.g. D.R., Nursery, NICU, or Home)
Lying-in Clinics/ Homes

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PRC I.D No. 0463446 Valid Until: December 10, 2011 PRC I.D No. Valid Until:
PNA No. 2011-038035 Valid Until: October 31, 2011 PNA No. Valid Until:
Date document is signed: Time: Date document is signed: Time:
Highest Nursing Degree Earned: Master of Arts in Nursing Highest Nursing Degree Earned:

44 57c/+c cccccc  "cc#.8#cc c c c c


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PRC I.D. No: 0211191 Valid Until: April 4, 2012
PNA No: 2011-038109 Valid Until: October 31, 2011
ADPCN No: 19519 Valid Until: May 31, 2011
Date document is signed: Time:
Highest Nursing Degree Earned: Master of Arts in Nursing
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