Get Application To Begin A Training Program - Nebraska Health And ...

Filling out the Application To Begin A Training Program in Nebraska is a crucial step for individuals pursuing a career in nursing home administration. This guide provides clear, step-by-step instructions to assist users in completing the application online accurately and efficiently.

Follow the steps to fill out the application successfully.

1. Click the ‘Get Form’ button to access the application form and open it in your web browser.
2. Provide your legal name in Section A. Ensure to fill in all parts of your name: first, middle, maiden (if applicable), and last.
3. Enter your mailing address including the street, city, state, and zip code. Accurate information is crucial for correspondence.
4. Fill in your date of birth and place of birth. Make sure the format is month/day/year.
5. Enter your contact information if you wish, including your phone number and email address for preferred correspondence.
6. Disclose your Social Security Number (SSN) and/or Alien Registration Number as required in the application. Remember that providing your SSN is mandatory.
7. In Section B, list your preceptor's name and the facility where your training will occur. Include the address and contact details.
8. In Section C, report any misdemeanor or felony convictions. Ensure that all details are provided to avoid future disciplinary actions.
9. Complete Section D by indicating the proposed dates of your training and the hours you will train daily and weekly.
10. Attach all necessary documents as required by the checklist, including your educational transcripts and any conviction or disciplinary action records.
11. Review your completed application for accuracy and completeness.
12. Once satisfied with your entries, save your changes. You may download, print, or share the form according to your needs.

Submit your completed application online today to begin your journey towards becoming a licensed nursing home administrator!