Get 2016 Take 2 Participant Registration Form - Cnor Nurses

Filling out the 2016 Take 2 Participant Registration Form is an important step for registered nurses looking to participate in the CNOR certification program. This guide provides clear and supportive instructions to help users complete the form correctly and efficiently.

Follow the steps to successfully complete your registration form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Type your legal name as it appears on your government-issued ID in the designated field. Ensure this information is accurate, as it will be used for official purposes.
3. Create an account at cc-institute.org if you do not already have one, and note your unique CCI Customer ID in the appropriate section of the form.
4. Fill in your facility's name and contact information, including email address and phone number, ensuring that the details are correct and up to date.
5. Provide the name and title of your Facility Administrator, along with the facility’s address, city, state, and zip code. This will help ensure proper communication regarding your registration.
6. In the payment information section, indicate whether your facility will pay the fee or if you will be self-paying. If self-paying, provide the necessary credit card details, including the cardholder name, card number, expiration date, CVV security code, and billing zip code.
7. Read the recitals and agreements carefully. Understand the terms of participation and payment responsibilities before signing.
8. Sign and date the form in the designated section to acknowledge your agreement to the terms.
9. Return this completed Participant Registration Form to your Facility Administrator. Please avoid sending it directly to CCI.
10. Once the facility has submitted the required documents to CCI and they have been approved, you will be informed of your enrollment.

Complete your Participant Registration Form online today to ensure your spot in the Take 2 program!