Cna Renewal Application Form Page 13
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14IF PAYING BY CREDIT/DEBIT CARD PLEASE COMPLETE THIS FORM AND
ATTACH IT TO THE CREDIT/DEBIT CARD AUTHORIZATION FORM.
A ONE-TIME CHARGE OF $3.00 FOR PROCESSING IS APPLIED TO
ALL PAYMENT CARD TRANSACTIONS
CHECK THE FEES THAT YOU ARE PAYING FOR.
RN/LPN/SN APPLICATION FEES:
RN/LPN EXAM FEE
$
300.00
RN/LPN RENEWAL FEE
$
160.00
RN/LPN ENDORSEMENT FEE
$
150.00
RN/LPN TEMPORARY LICENSE FEE (Reg or 48 Hr.)
$
50.00
SCHOOL NURSE
$
75.00
SCHOOL NURSE RENEWAL
$
25.00
FINGER PRINT FEE
$
50.00
ADVANCED PRACTICE APPLICATION FEES:
NP/CNM/CNS APPLICATION FEE
$
150.00
NP/CNM PRESCRIBING & DISPENSING FEE
$
150.00
TEMPORARY NP/CNM/CNS FEE
$
35.00
CRNA CERTIFICATION FEE
$
150.00
CRNA TEMPORARY CERTIFICATION FEE (Reg or 48 Hr.)
$
35.00
CNA APPLICATION FEES
CNA EXAM CERTIFICATE FEE (OPTIONAL)
$
50.00
CNA RENEWAL CERTIFICATE FEE (OPTIONAL)
$
50.00
CNA ENDORSEMENT FEE
$
50.00
OTHER FEES:
DUPLICATE RN/LPN LICENSE FEE
$
25.00
DUPLICATE CNA CERTIFICATE FEE
$
25.00
ADDRESS CHANGE FEE
$
25.00
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