Step 3. Maryland Application Submission

2. Complete the Application Form:

• • Fill out the form in ALL CAPS using black or blue ink.
  • Answer ALL questions completely and accurately.
  • Include proof of current national certification if applicable.

3. Application Details:

• • Personal Information: Provide your full name, date of birth, social security number, and contact details.
  • Marital Status: Indicate your marital status.
  • Address: Provide your current address, including your apartment number if applicable.
  • Educational Background: List your educational background, including the type of basic nursing education program (e.g., Baccalaureate in Nursing, LPN Certification).
  • License Information: Indicate the states where you are licensed, whether active or inactive.
  • Employment History: Confirm that you have practiced nursing for at least 1,000 hours in the last five years or are a new graduate.
  • Criminal Record: If you have been convicted of any misdemeanors or felonies or have had any disciplinary actions taken against your license, provide a detailed explanation and relevant court documents.

4. Signature and Photo Attachment:

• • Sign and date the application form.
  • Attach a recent passport-style full-face photograph to the form.

5.  Affidavit for Applicants without ITIN and SSN

• • If you do not have a Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN), download the “Affidavit for Licensure/Certification Pursuant to § 10-119.3(B)(3)(1)(2) of the Family Law Article, Annotated Code of Maryland” from the MBON website.
  • Complete and sign the affidavit.
  • Submit the signed affidavit along with your application.

6. Submit with CHRC (Criminal History Record Check) to CJIS(Criminal Justice Information System):

• • You must submit the CHRC verification along with your application.
  • Applications without CHRC verification will not be processed.
  • DO NOT SEND ORIGINAL FINGERPRINT COPY TO MBON

7. Fee Payment:

• • The application fee for endorsement is $100.
  • If you are applying for a temporary license, there is an additional fee of $40. (optional)
  • Payment should be made by check or money order payable to the Maryland Board of Nursing. Cash is not accepted.
  • The fees are non-refundable.

Visit a local bank or post office that offers international money order services.

Request an international money order payable in US dollars.

Fill in the recipient’s details:

Payee: Maryland Board of Nursing
Address: 4140 Patterson Avenue Baltimore, MD 21215-2254

Refer to the Maryland Board of Nursing website for the current fee
The fees are non-refundable.

 

8. Submit the Application and Affidavit:

• Mail the completed application form, all required documents, and the payment to the following address:

Maryland Board of Nursing
4140 Patterson Avenue
Baltimore, MD 21215-2254
Attn. Endorsement Department

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Additional Instructions:

• • Add CJIS Tracking Number and Email: Write the CJIS Tracking Number and your personal email address in the blank space on the back of the application form.
    
    
  • CJIS Tracking Number: This is the 12-digit number below the fingerprint card’s barcode.

• • Include Fingerprint Scan: Include a scanned copy of the completed fingerprint card with your application. NEVER INCLUDE ORIGINAL FINGERPRINT CARD.

• • Keep Copies: For your records, make copies of all submitted documents, including the application form and payment receipt.

• • Verification: Use the “Look-Up-A-License” feature on the MBON website to check the status of your application.