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Hong Kong College of Surgical Nursing
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Application for Fellow Member Vetting Checklist
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Name:
HKANM Ordinary Membership No.
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Admission Criteria:
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Self-declaration on no criminal conviction or professional misconduct
YES
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2Copy of Registered Nurse certificate from Nursing Council of Hong KongYES
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Copy of valid registered nurse practising certificate
YES
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Copy of HK Academy of Nursing & Midwifery Ordinary Membership Certificate
YES
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Post Membership Program Documents
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a. specialty competency skill log
YES
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b. two comprehensive case studies
YES
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c. one completed project
YES
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d. a total of 100 score on recognized significant contributions with evidence
YES
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e. six or more sets of periodic assessment forms
YES
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Copy of HKCSN Fellow Assessment result / letter#
YES
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Copy of curriculum vitae
YES
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8Evidence of achieved 60 CNE points within 3-year cycle which include 45 CNE points are Surgical-relatedYES
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# to be submitted after successfully passed assessment
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9Working Experience
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From (MM/YY)
To (MM/YY)
Sub-Total (MM/YY)
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Accumulate 6 years in the specialty in the most recent 9 years:YES
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Current 3 years must be working in the specialty applied for:
YES
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Approved for Fellow Membership:
YESNO
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Follow up with supplementary information required
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Endorsed by HKCSN Administration & Registration Committee
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Signature & Name
(1)(2)
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Date
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