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NATIONAL LEAGUE for NURSING
CERTIFICATE OF CONTINUING EDUCATION
PARTICIPANT INFORMATION
NAME:

____________________________________________

_ __________________________________________

Last

ADDRESS: ___________________________________________

First

Middle

______________________________

_________

City

State

Street

RN LICENSE #: _________________________________________________

________________

____________________
Zip Code

STATE OF LICENSURE: ________________________________

PROGRAM INFORMATION
PROGRAM NUMBER:
PROGRAM TITLE:
SPONSORED BY:
DATE:
# OF CONTACT HOURS:
# OF CEUS:

02062014
2014 NLN Leadership Conference – Academic Leadership Excellence: Creating Inclusive Environments
National League for Nursing
February, 8th 2014
9.25
.925
_____________________________________________________

Beverly Malone, PhD, RN, FAAN
Chief Executive Officer
The National League for Nursing has been approved as an Authorized Provider by the International Association for Continuing Education and Training (IACET), 8405 Greensboro Drive, McLean, VA
22102. Specific provider numbers are assigned by the following states: Alabama (ABNP0382), California (CEP 13722), Delaware (DE 129), District of Columbia (CEBroker 50-2869), Florida (FBN3341),
Kentucky (1-0013), Louisiana (LSBN 37), West Virginia (WV2000-0336RN). Kentucky Board of Nursing approval of an individual nursing continuing education provider does not constitute endorsement
of program content. This activity meets [Type II] criteria for mandatory continuing education requirements toward relicensure as established by the Board of Nurse Examiners for the state of Texas.
DISCLAIMER: Although the National League for Nursing (NLN) has reviewed and approved this course for CEUs, we cannot guarantee or take responsibility for the accuracy or quality of the material
presented, nor do we necessarily endorse, support, or recommend any products mentioned, opinions expressed, or actions/decisions suggested. Completion of this program does not authorize persons to
practice outside the scope of practice defined by their State Board(s) of Nursing.
This certificate must be retained by the licensee for a period of 7 years. Do not send it to a State Board of Nursing unless requested to do so.

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Leadership 2 8_14

  • 1. NATIONAL LEAGUE for NURSING CERTIFICATE OF CONTINUING EDUCATION PARTICIPANT INFORMATION NAME: ____________________________________________ _ __________________________________________ Last ADDRESS: ___________________________________________ First Middle ______________________________ _________ City State Street RN LICENSE #: _________________________________________________ ________________ ____________________ Zip Code STATE OF LICENSURE: ________________________________ PROGRAM INFORMATION PROGRAM NUMBER: PROGRAM TITLE: SPONSORED BY: DATE: # OF CONTACT HOURS: # OF CEUS: 02062014 2014 NLN Leadership Conference – Academic Leadership Excellence: Creating Inclusive Environments National League for Nursing February, 8th 2014 9.25 .925 _____________________________________________________ Beverly Malone, PhD, RN, FAAN Chief Executive Officer The National League for Nursing has been approved as an Authorized Provider by the International Association for Continuing Education and Training (IACET), 8405 Greensboro Drive, McLean, VA 22102. Specific provider numbers are assigned by the following states: Alabama (ABNP0382), California (CEP 13722), Delaware (DE 129), District of Columbia (CEBroker 50-2869), Florida (FBN3341), Kentucky (1-0013), Louisiana (LSBN 37), West Virginia (WV2000-0336RN). Kentucky Board of Nursing approval of an individual nursing continuing education provider does not constitute endorsement of program content. This activity meets [Type II] criteria for mandatory continuing education requirements toward relicensure as established by the Board of Nurse Examiners for the state of Texas. DISCLAIMER: Although the National League for Nursing (NLN) has reviewed and approved this course for CEUs, we cannot guarantee or take responsibility for the accuracy or quality of the material presented, nor do we necessarily endorse, support, or recommend any products mentioned, opinions expressed, or actions/decisions suggested. Completion of this program does not authorize persons to practice outside the scope of practice defined by their State Board(s) of Nursing. This certificate must be retained by the licensee for a period of 7 years. Do not send it to a State Board of Nursing unless requested to do so.