:: Contact Details
Nurse’s Name
Office Location	Cochin Delhi
:: Education Qualification
	GNM BSc MSc
:: Interested for AAS Training
	Yes No
If Yes, Please specify
	Computer For 5 Days IELTS For 1/2/3 Months RN Training For 3 Months Lecture by USA Nursing professor’s For 5 Days
• Critical Care Nursing & Thinking For 2 Days • Advanced Electrocardiography For 2 Days • Advance Nursing Review for RN/CRNE Exam For 1 Days
Clinical Area
Total Experience
Present Employer
Present Designation
:: Interested for AAS Recruitment
	National International
If National Please Specify
State
If International, Please Specify
Country
State
Licensure Status if any
IELTS
NCLEX/CRNE/Or any
:: Interested for AAS NCLEX Services
	Yes No
If Yes, AAS can do your NCLEX Paper work. Ask for Fee Details
Payment Details
Contact Address
Email Address
Mobile No.
Home Phone No.
Terms and Conditions – Candidate should reach the venue 15 minutes before the class time, Candidate must bring this Acknowledgement slip/ID Card on the class day, Registration is Non-Transferable, Candidate should bring Note book and Pen with them, Handouts will be provided by AAS.
Yes I Agree with the Terms and Conditions