To Be Filled By Capital Letters In English (* Indicates Mandatory)
I declare that the particulars stated in this application and the documents attached are true, correct and complete and the information contained herein remains true, correct and coplete to date. I undertake to inform INA of any data discrepancy (e.g inaccurate/outdated data) and I am aware that I may be asked to provide more information to the INA, If necessary. To the best of my knowledge and belief, I have not withheld any material fact.
I acknowledge that the INA reserve all rights to withhold registration or to remove my name from the appropriate register and/or take any action it deems fit. I also understand and give my consent for the INA to make any enquiries or to obtain any information & documents whice it may require to verify my qualifications and fitness to practise.
I acknowledge that the INA reserve all rights to receive, collect and/or tranmit the avove personal data or other authorities or argencies if required to do so for the purpose of carrying out its under the Nurses & Midives Act (NMA) and/or for compliance with any other Acts and subsidary legislations. I also acknowledge that INA is not liable for any damage or loss caused to me in couse of my using the Professional Registration System (PRS) due to data errors in the personal data I provide. The personal data collected will be kept in the strictest confidence and access restricted only to authorised persons. To safegaurd all personal data, all electronic storage and transmission of personal data are secured through appropriate security technology.
I agree to allow this application including all of the information contained, and declarations set out, in this application to be accessed by prospective employer.