Get Niaaa Personal Data Form

Filling out the Niaaa Personal Data Form online can seem daunting, but with clear guidance, you can complete it with confidence. This comprehensive guide will walk you through each section of the form, ensuring you understand what information is required.

Follow the steps to complete the form efficiently.

1. Click ‘Get Form’ button to obtain the Niaaa Personal Data Form and open it in the editor.
2. Begin with personal identification details. This includes entering your NIAAA membership number, birth date, and full name (last, first, and middle). Ensure that all entries are printed or typed clearly.
3. Provide your current position, school, and business address including street address, city, state, and zip code. After that, fill in your home address using the same format.
4. Enter contact information: home phone, fax phone, and email address. Make sure to double-check the accuracy of each contact detail.
5. Proceed to the Basic Eligibility section. Confirm that you have completed the necessary education requirements and training courses. You will need to check off items that apply and ensure you have attached documentation where required.
6. Complete Section I – Education by listing your college degrees along with the institution name, city/state, and completion date for each degree.
7. In Section II – Niaaa Leadership Training Institute, indicate the completion of LTC 501 and LTC 502 by providing the location and date of completion. Copies of your certificates must accompany the form.
8. Read and acknowledge the NIAAA Code of Ethics by signing the form. Make sure to include the printed name and title of the person verifying your application along with their signature.
9. Finally, include payment information for the processing fee. Select the appropriate amount based on your membership status and either provide a check, money order, or credit card details.
10. Review all information for accuracy, save changes, and proceed to download or print the completed form before sharing it with the NIAAA Certification Committee.

Start completing your Niaaa Personal Data Form online now for a smoother application process.