Ga Board Of Nursing Form PDF Details

The Georgia Board of Nursing (GBON) Form is used to apply for licensure as a registered nurse in the state of Georgia. The form can be submitted online or by mail, and must be accompanied by the appropriate documentation. In order to complete the application, you will need to provide your name, date of birth, Social Security number, education information, and employment history. You will also need to have your fingerprints taken and pass a criminal background check. Once the application is processed, you will be notified of your eligibility to take the National Council Licensure Examination for Registered Nurses (NCLEX-RN). For more information on how to apply for nursing licensure in Georgia, please visit our website. Thank you for choosing GBON as your source for nursing news and information!

Form NameGa Board Of Nursing Form
Form Length1 pages
Fillable fields0
Avg. time to fill out15 sec
Other namesgeorgia nursing inactive printable, ga nursing application inactive, georgia of inactive, nursing inactive ga

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237 Coliseum Drive • Macon, Georgia 31217 • (844) 753-7825


A currently licensed registered professional or practical nurse who wishes to maintain his or her license but who does not wish to practice nursing in this state may apply for inactive licensure status by submitting an application for inactive status. A licensee granted inactive status is exempt from filing a biennial license renewal application and paying a license renewal fee. A licensee who holds an inactive license shall not practice nursing under the inactive license.

An inactive license may be changed to active status by filing an application for reinstatement with the Board, complying with reinstatement requirements, and paying a reinstatement fee, as determined by the Board. Applicants must be able to demonstrate to the satisfaction of the Board that he or she has maintained current knowledge, skill and proficiency in the practice of nursing and that he or she is mentally and physically able to practice nursing with reasonable skill and safety.

Applicants for reinstatement who have not practiced as a registered nurse or licensed practical nurse for at least five hundred hours within the previous four years must complete a Board approved reentry program. Applicants for reinstatement who have practiced as a registered nurse for at least five hundred hours within the previous four years must complete one of the five competency requirements within two years preceding the date of application for reinstatement. The Board may require the passage of an examination or other competency assessments. The Board, in its discretion, may impose any remedial requirements deemed necessary. Reinstatement of the license is within the discretion of the Board.

For additional information please see Board Rule 410-06.

Please complete the following form and submit it by fax to 877-371-5712; by email to; or by mail to 237 Coliseum Drive, Macon, Georgia 31217.


Legal Name:


License Address




Zip Code


Email Address:



Social Security Number:

License Number:



I understand that I am applying to have my license placed on inactive status. While my license is inactive I understand that I cannot practice using the inactive license in the State of Georgia.



Revised January 2017