Follow the steps to successfully complete your application online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin filling out the application by selecting the application type. Indicate whether you are applying for an initial certificate or reactivation of a certificate, checking only one box.
3. Provide your personal information, including your full name, maiden or previous name (if applicable), Nevada lab license number, social security number (required), birth date, email address, and mailing address. Make sure this information is accurate and complete to avoid delays.
4. Input the laboratory information. Include your employer or laboratory name, laboratory street address, phone number, and fax number.
5. Complete the personal information section with your current phone number. Ensure all sections are fully filled out as regulations may require complete disclosure.
6. Address the application attestations. If you do not have an electronic form of communication, check the appropriate box attesting this situation.
7. Provide child support information by checking the box that corresponds to your situation. This section is mandatory for processing your application.
8. Indicate if you currently hold a Nevada laboratory personnel certificate and, if applicable, provide your certification number.
9. If you are an initial applicant, complete the required certifications by checking both boxes that confirm you have included the necessary documentation.
10. For reactivation applicants, check both boxes confirming you have attached CEU certificates and that your certification expired no more than five years ago.
11. Read and understand the statement regarding false information. Provide your signature and date to attest to the truthfulness of the information supplied.
12. Finally, prepare your completed application package. Include the signed application, a $75 fee, and all required documents. Ensure that all documentation is collected before submission.
13. Submit your completed application to the address provided. Allow up to six months for processing.

Begin filling out your application online today to take the next step in your certification journey.