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    Attestation - BCCNM Registration Fees - 2023

    Uploaded by

    Kaye Marie Oporto
    The document is a registration fee reimbursement form for a nurse in British Columbia. It certifies that the nurse [1] is registered with the British Columbia College of Nurses and Midwives, [2] has paid their registration fee for the current period, and [3] has not received reimbursement from any other source. By signing, the nurse attests that the information is true and will repay the fee if the attestation is found to be false.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Attestation - BCCNM Registration Fees - 2023

    Uploaded by

    Kaye Marie Oporto
    312 views1 page
    The document is a registration fee reimbursement form for a nurse in British Columbia. It certifies that the nurse [1] is registered with the British Columbia College of Nurses and Midwives, [2] has paid their registration fee for the current period, and [3] has not received reimbursement from any other source. By signing, the nurse attests that the information is true and will repay the fee if the attestation is found to be false.

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    The document is a registration fee reimbursement form for a nurse in British Columbia. It certifies that the nurse [1] is registered with the British Columbia College of Nurses and Midwives, [2] has paid their registration fee for the current period, and [3] has not received reimbursement from any other source. By signing, the nurse attests that the information is true and will repay the fee if the attestation is found to be false.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    312 views1 page

    Attestation - BCCNM Registration Fees - 2023

    Uploaded by

    Kaye Marie Oporto
    The document is a registration fee reimbursement form for a nurse in British Columbia. It certifies that the nurse [1] is registered with the British Columbia College of Nurses and Midwives, [2] has paid their registration fee for the current period, and [3] has not received reimbursement from any other source. By signing, the nurse attests that the information is true and will repay the fee if the attestation is found to be false.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
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    REGISTRATION FEES: BRITISH COLUMBIA COLLEGE OF NURSES AND MIDWIVES

    I, fgnnnnnnn, am an employee of Interior Health (the “Employer”) and a nurse registered with the British Columbia College of
    Nurses and Midwives (“BCCNM”). I am entitled to have my BCCNM registration fee reimbursed by the Employer pursuant to
    Article 57.05(B) of the 2022 – 2025 Nurses Bargaining Association Collective Agreement.

    By signing below, I certify the following:

    (a) I am a registrant of the BCCNM in good standing;


    (b) I paid my BCCNM registration fee for the period from April 1, 2023 to March 31, 2024 (the “Registration Fee”);
    and
    (c) I have not applied for or received reimbursement of the Registration Fee from any other employer or
    organization.

    I understand that if this attestation is found to be false or untrue it may result in discipline and/or a requirement to repay the
    Employer the Registration Fee.

    By my signature below, I attest that the information set out in this form is true and accurate.

    Date: Click or tap to enter a date.

    Employee Number: Click or tap here to enter text.


    Employee Number can be found on iSite [include zero(s)]

    Birth Year: Click or tap to enter a date.


    For Confirmation of Employee Number

    Print Name: Click or tap here to enter text.

    Signature:

    * As per the Canada Revenue Agency, Reimbursement of non-taxable professional dues cannot be deducted from employment income *

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