VT2 Attestation

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VT2 Attestation

The following form MUST be completed before a Certificate of Attendance can be issued. Complete the form in its entirety and submit with 7 days of webinar event.

ATTESTATION FORM VT2

Certificate of CEU Credits

Date*
Date Format: MM slash DD slash YYYY
Event Name*
Number of Hours*
Entered number of hours attended
CEU Requested*
- NAB
- NV BELTCA
- NV Nursing Board
- NV Social Worker
- NV Occupational Therapy
- Dietitian
- General
Select all of the educational organizations you want reported
Other Board
Attestation Statement*
Attest
By checking the Attest field above and providing your name below, I hereby attest that all information entered is accurate as related to the number of hours attended during this training event.
Name*
First Last