[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-327262-105":59,"doc-detail-327262-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","aclpn-recertification-application-form-327262","ACLPN Recertification Application Form","","ACLPN recertification application form for HANCB includes applicant identity and contact details, ACLPN certificate information, and LPN/LVN licensure data such as initial and last recertification years, state of licensure, license number, and license expiration date. The form collects HIV nursing practice specifics (percent of time, primary role, professional emphasis, practice setting, experience, employment status, location, and academic level) plus other certifications, ANAC/CANAC membership, optional demographics, and a declaration. It also provides credit card payment fields and tracks continuing education in Categories I through IV with required hours and totals.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/aclpn-recertification-application-form-327262/327262/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/aclpn-recertification-application-form-327262/327262.png","ImageObject",300,407,{"name":92,"@type":93},"Ben Jamin","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What information is required for ACLPN and LPN/LVN licensure?","Question",{"text":113,"@type":114},"The form requests ACLPN certificate number, initial and last certification recertification years, state of licensure, LPN license number, and LPN license expiration date, along with applicant contact information.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How does the form measure HIV nursing practice involvement?",{"text":118,"@type":114},"It collects the applicant’s current percent of time working in HIV nursing and asks for the primary position, professional HIV emphasis area, current practice setting, and years of HIV nursing experience.",{"name":120,"@type":111,"acceptedAnswer":121},"What are the continuing education categories and their hour limits?",{"text":122,"@type":114},"Category I (HIV nursing) requires 25 hours minimum; Category II (other nursing education) allows up to 12 hours; Category III (academic courses) allows up to 25 hours; Category IV (professional activities) allows up to 10 hours. Tables are provided to list course details and totals.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},327262,1790095733,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146},2336478466772,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","# ACLPN RECERTIFICATION APPLICATION FORM\n\n\n| Last Name   |  | First Name   |  |\n| --- | --- | --- | --- |\n| Address   |  | City,State,Zip Code   |  |\n| Home Phone   |  | Work Phone   |  |\n| Cell Phone   |  | Email   |  |\n\n\n| ACLPN Information   |  | LPN/LVN Information   |  |\n| --- | --- | --- | --- |\n| Year of Initial  \u003Cbr>Certification   |  | State of Licensure   |  |\n| Year of Last  \u003Cbr>Recertification   |  | LPN License Number   |  |\n| ACLPN Certificate  \u003Cbr>Number   |  | LPN License Expiration  \u003Cbr>Date   |  |\n\nSubmit this form and pay online via the HANCB website.  \nOr mail completed form with appropriate fee to:  \nHANCB Recertification11230 Cleveland Ave NW\\#986Uniontown,OH 44685  \nRecertification Fee:$100  \nLate Fee:$50(due on applications submitted after certificate expiration date)  \n## A.Percent of Time Currently Working in HIV Nursing\n\nO Less than 25%  \n○ 25-50%  \nO 51-75%  \nO More than 75%  \n## B.Primary Position(Select only one response)\n\nO Clinical Nurse SpecialistO ConsultantO Counselor  \nO Director/Assistant DirectorO Head Nurse/Nurse Manager○ Infection Control PractitionerO LPN/LVN  \nO Nurse Case Manager/CoordinatorO Nurse Educator/Faculty MemberNurse PractitionerPatient Educator  \nSales/Marketing/lndustry:Nursing RepStaff nurse/clinicianOther-please specify  \n## C.Area of Professional HIV Emphasis\n\nO AdultO PediatricsO Both adult and pediatrics  \nBackground InformationPlease complete the following information:  \n## D.Current Practice Setting(Select only one response)\n\nO Clinical Trial Group  \nO Community-Based OrganizationO Family Planning/STDO Forensic Setting(jail,prison)O HIV Testing CenterO Home CareO Hospice  \nO Inpatient:community hospital○ Inpatient:university affiliated hospitalO Long-term Care FacilityO Outpatient/ambulatory careO Physician's office○ Primary Prevention Program○ Private/Group PracticeO Public/community healthO School of Nursing  \n○ Substance Abuse Treatment Center○ Other-please specify  \n## E.Experience in HIV Nursing\n\nO 3-6 years  \n○ 7-10 years  \nO More than 10 years  \n## F.Employment Status\n\nO Full-time  \nO Part-time  \nO Unemployed  \nO Retired  \n## G.Primary Practice Location\n\nO Mixed  \nO Rural  \nO Suburban  \nO Urban (less than 1 million population)  \nUrban(more than 1 million population)  \nNot applicable  \n## H.Highest Academic Level Earned\n\nO Associate Degree,Nursing  \nO Baccalaureate,Nursing  \nO Baccalaureate,Other  \nO Diploma in Nursing  \nO Doctorate in Nursing  \nO Doctorate,Other  \nO LPN/LVN Certificate  \nMasters,Nursing  \nO Masters,Other  \nO Other  \n### 1.Other Certifications Held(ALL that apply)\n\nO None  \nO CCRN  \nO CEN  \nO CIC  \n○ CRNH  \nO OCN  \nO RN,C  \nO I  \nRN,CS  \nO Other  \n## J.Are you currently a member of ANAC/CANAC?\n\nO No  \nO Yes  \nIf yes,please provide your membership number  \n## Optional Information:\n\nRace/Ethnicity  \nO African American/BlackO Asian/Pacific IslanderO Hispanic/Latino/LatinaO Native AmericanO WhiteO Other  \nAge Range:  \n○ Under 25  \n◎ 25-29  \nO 30-39  \nO 40-49  \nO 50-59  \nO 60 or older  \nGender:  \nO FemaleO MaleO TransgenderO Non-binary○ Prefer not to answer  \nDeclaration  \nI affirm that all statements given on this application are true and correct,to the best of myknowledge,and that HANCB is hereby authorized to contact any organization or individual listedhereon to verify my continuing education or licensure history  \nSignature of ACLPN                                                                Date                                                                                                \n## CREDIT CARD PAYMENT\n\nIf you want to charge your recertification fee on your credit card,please provide the following information:  \nName(as it appears on the card)  \nBilling Address(as it appears on the statement)  \nCharge my credit card for the total fee of $                    \nCard Type:  \no American Express  \no MasterCard  \no VISA  \nExpiration Date(month/year):    /    \nCVV\\#                                                                \nCard Num","cbCaihpZdbOTaatR","https://ap.wps.com/l/cbCaihpZdbOTaatR","pdf",1036417,18,"English","# ACLPN Recertification Application Form\n## A. Percent of Time Currently Working in HIV Nursing\n## B. Primary Position\n## C. Area of Professional HIV Emphasis\n## D. Current Practice Setting\n## E. Experience in HIV Nursing\n## F. Employment Status\n## G. Primary Practice Location\n## H. Highest Academic Level Earned\n## I. Other Certifications Held\n## J. ANAC/CANAC Membership\n## Optional Information and Declaration\n## Credit Card Payment\n## Category I - HIV Nursing Continuing Education (25 hours minimum)\n## Category II - Other Nursing Continuing Education (12 hours maximum)\n## Category III - Academic Courses (25 hours maximum)\n## Category IV - Professional Activities (10 hours maximum)","[{\"question\":\"What information is required for ACLPN and LPN/LVN licensure?\",\"answer\":\"The form requests ACLPN certificate number, initial and last certification recertification years, state of licensure, LPN license number, and LPN license expiration date, along with applicant contact information.\"},{\"question\":\"How does the form measure HIV nursing practice involvement?\",\"answer\":\"It collects the applicant’s current percent of time working in HIV nursing and asks for the primary position, professional HIV emphasis area, current practice setting, and years of HIV nursing experience.\"},{\"question\":\"What are the continuing education categories and their hour limits?\",\"answer\":\"Category I (HIV nursing) requires 25 hours minimum; Category II (other nursing education) allows up to 12 hours; Category III (academic courses) allows up to 25 hours; Category IV (professional activities) allows up to 10 hours. Tables are provided to list course details and totals.\"}]","ACLPN Recertification Application Form | PDF",1789976846,45]