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.