Nurse Registration

Please complete below form in full.

Name * First Last
Please state the actual name as specified with SNB for verification purposes. Failing to do so will cause a delay in accepting your application.
NRIC No./ FIN No. *
Date of Birth * / MM / DD YYYY
Gender * Female Male
Email *
Mobile Phone *
Mobile Phone Telco * Singtel Starhub M1
Specify the mobile telephone company subscribed for the registered mobile phone number.
Are you a registered with SNB? * Yes - Registered Nurse (RN) Yes - Enrolled Nurse (EN) No - None of the above
Do you have a Professional Indemnity Insurance? * Yes No
Are you holding a Full-Time job now? * Yes No
Will you work on short-term live-in (stay-in) cases? * Yes No
Preferred Nursing Assignment * Routine Emergency
Shift Duties * Day Shift (8am to 8pm) Night Shift (9pm to 7am)
Nursing Procedure * Wound Care Tube Care Injection
Specialized Nursing *

Example : Geriatic care, cancer care, post-stroke care, etc
Preferred Job Location * North South/ City East West
Brief Details of Past Nursing Experience *
I agree that Singapore Home Nursing should not be held responsible for the nursing services rendered by me. I fully agree to indemnify Singapore Home Nursing (a service rendered by Dynamic eBiz) in the event of any improper, negligent practice; misconduct or misuse by me. * I Agree I Do Not Agree
I acknowledge that I have read and agree to the terms of services as specified under www.SingaporeHomeNursing.com * I Agree and Accept I Do Not Agree and Accept
Type the letters you see in the image below.