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The application explains requirements for online submission, payment form inclusion, and handling incomplete or illegible entries. It also covers ADA testing accommodations, including timing, required ADA packet submission, and exceptions for candidates taking the oral audio exam. 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Candidates applying for the oral (audio) exam do not need to apply for ADA accommodations.","https://schema.org",{"og:url":83,"og:type":123,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":125,"canonical":83},"index,follow",{"doc_id":127,"site_id":62},443187,1790703214,{"code":4,"msg":5,"data":130},{"doc_id":127,"user_id":131,"nickname":92,"user_avatar":132,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":133,"file_id":134,"file_url":135,"file_type":136,"file_size":137,"view_count":4,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":138,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":139,"faqs":140,"seo_title":141,"seo_description":67,"update_tm":128,"read_time":142},962084925636,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","New York Certified Nursing Assistant  \nExamination Application  \nInstructions:  \n􀁸 Please go to: [www.prometric.com/NurseAide/NY](www.prometric.com/NurseAide/NY) to print the current version of this application and all other forms. DO NOT submit photocopies as this may impact the ability to process the application.  \n􀁸 Incomplete, blurred or illegible forms will not be processed.  \n􀁸 To apply online please go to: [www.prometric.com/NurseAide/NY](www.prometric.com/NurseAide/NY)  \n􀁸 All submitted applications must include the Payment Form at the end of the application.  \n􀁸 Please mail completed original forms to Prometric, ATTN: NY Nurse Aide Program, 6211 Greenleigh Avenue, Suite 400, Middle River, MD 21220  \nThe name you provide on this application must match EXACTLY the name on your governmentissued identification you will provide on the day of testing. If the name does not match EXACTLY, you will not be permitted to take your exam and will forfeit any test fees.  \nIf you have previously taken a nurse aide exam with Prometric and your legal name has changed since then, you must provide a copy of acceptable legal documentation along with this application. Acceptable documents include marriage certificate; divorce decree; birth certificate; and legal name change court documents. Prometric will be unable to process your application until the legal acceptable documents are received.  \n􀁸 If applying for Testing Accommodations under the Americans with Disabilities Act (ADA):  \n􀁸 Please go to to [www.prometric.com/nurseaide](www.prometric.com/nurseaide) to print the required ADA Accommodations Request Packet. This packet MUST be completed and submitted with this application.  \n􀁸 Fill out the box below.  \nNote: Candidates applying to take the Oral (audio) Exam do not need to apply for ADA accommodations.  \nI am applying for Americans with Disabilities Act (ADA) accommodations. I am requesting testing accommodations and have included the required ADA Accommodations Request Packet along with this application. I understand I must request accommodations 30 days in advance of the test date and not all accommodations can be approved.  \n􀂆 Yes 􀂆 No  \nCandidate Information  \nAll fields marked with * are required Print one number/letter in each box where required  \n\n| *Have you taken a Certified Nurse Aide exam with Prometric? 􀂆 Yes 􀂆 No |  |  |\n| --- | --- | --- |\n| *Social Security Number\u003Cbr>􀀍 􀀍 􀀍 - 􀀍 􀀍 - 􀀍 􀀍 􀀍 􀀍 |  |  |\n| *First Name 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 |  | Middle Initial\u003Cbr>􀀍 |\n| *Last Name 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 |  |  |\n| *Date of Birth (Month/Day/Year)􀀍􀀍/ 􀀍􀀍/ 􀀍 􀀍 􀀍 􀀍 | Previous name (if applicable): |  |\n\n. .  \n\n| *Street Address (including Apt. number or P.O. Box, if applicable) |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- |\n| *City *State *ZIP Code\u003Cbr>􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 􀀍 |  |  |  |  |  |\n| *County (first four letters only) |  |  | * Phone Number (including area code)􀀍 􀀍 􀀍 - 􀀍 􀀍 􀀍 - 􀀍 􀀍 􀀍 􀀍 |  |  |\n| *Email Address (application will not be processed without an email address) |  |  |  |  |  |\n| Ethnic Group (optional)(check one box)\u003Cbr>􀂆 American Indian or Alaskan Native 􀂆 Asian American/Pacific Islander 􀂆 Black/African American\u003Cbr>􀂆 Mexican American 􀂆 Other Hispanic or Latin American 􀂆 White\u003Cbr>􀂆 Other |  |  |  |  |  |\n| Gender (check one) 􀂆 Female 􀂆 Male |  |  |  |  |  |\n| Education Level (Optional) Check only one box next to your highest education level completed.\u003Cbr>􀂆 4th grade or less\u003Cbr>􀂆 Some High School, did not graduate\u003Cbr>􀂆 One or two years of college\u003Cbr>􀂆 Between 5th and 8th grades\u003Cbr>􀂆 High School diploma or GED\u003Cbr>􀂆 Two-year college degree |  |  |  |  |  |\n| *Current Nursing Home Employment Status: Full Time  Part Time  Not Employed\u003Cbr>(If you are currently working in a nursing home, have your Employer complete Section 2 of this application) |  |  |  |  |  |\n| Do you currently hold a certification as a nurse aide or are you listed on the nurse aide registry in any state other than ","cbCaijdZg9Tq2dSx","https://ap.wps.com/l/cbCaijdZg9Tq2dSx","pdf",241645,"English","# Instructions\n## Submission requirements and name verification\n## ADA testing accommodations\n# Candidate Information\n## Required fields\n## Prior Prometric exam and registry status\n# Certification Option/Eligibility\n# Training Information\n## Program coordinator section\n# Employment Information\n## Employer facility section","[{\"question\":\"Where can candidates print the current New York nurse aide application and other required forms?\",\"answer\":\"Candidates are instructed to go to www.prometric.com/NurseAide/NY to print the current version of the application and all other forms.\"},{\"question\":\"What happens if the name on the application does not match the government-issued ID exactly?\",\"answer\":\"Candidates are not permitted to take the exam if the name does not match EXACTLY, and any test fees are forfeited.\"},{\"question\":\"How should candidates request ADA testing accommodations?\",\"answer\":\"Candidates must print the required ADA Accommodations Request Packet, complete and submit it with the application, and request accommodations 30 days in advance (not all accommodations can be approved). Candidates applying for the oral (audio) exam do not need to apply for ADA accommodations.\"}]","New York Certified Nursing Assistant Examination Application - Instructions and Candidate Information | PDF",15]