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For partial approved nursing education, applicants must provide official transcripts (including via specified methods) or a Board-approved foreign transcript evaluation.",{"name":70,"@type":61,"acceptedAnswer":71},"What must applicants provide if they answer “Yes” to background or disciplinary questions?",{"text":72,"@type":64},"Applicants must submit a detailed letter of explanation and official certified/true-test copies of relevant court documents for misdemeanor or felony questions, plus character reference letters. For licensing discipline and abuse/neglect/misappropriation, they must provide detailed explanations and official copies of regulatory or related documentation/orders.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},255343,1789288611,{"code":4,"msg":82,"data":83},"success",[84,89,94,99,104,109,113,118,123],{"id":85,"doc_module":22,"doc_module_name":25,"category_name":86,"show_sort_weight":87,"slug":88},11,"Presentations",90,"presentations",{"id":90,"doc_module":22,"doc_module_name":25,"category_name":91,"show_sort_weight":92,"slug":93},12,"Resumes",80,"resumes",{"id":95,"doc_module":22,"doc_module_name":25,"category_name":96,"show_sort_weight":97,"slug":98},14,"Invoices",70,"invoices",{"id":100,"doc_module":22,"doc_module_name":25,"category_name":101,"show_sort_weight":102,"slug":103},15,"Posters",60,"posters",{"id":105,"doc_module":22,"doc_module_name":25,"category_name":106,"show_sort_weight":107,"slug":108},16,"Social Media",50,"social-media",{"id":110,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":111,"slug":112},17,40,"forms",{"id":114,"doc_module":22,"doc_module_name":25,"category_name":115,"show_sort_weight":116,"slug":117},18,"Letters",30,"letters",{"id":119,"doc_module":22,"doc_module_name":25,"category_name":120,"show_sort_weight":121,"slug":122},21,"Paper Templates",5,"papers-templates",{"id":124,"doc_module":22,"doc_module_name":25,"category_name":125,"show_sort_weight":4,"slug":126},158,"General","general-158",{"code":4,"msg":82,"data":128},{"doc_id":79,"user_id":129,"nickname":42,"user_avatar":130,"doc_module":22,"category_id":110,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":121,"language":136,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":12,"update_tm":80,"read_time":26},962084926284,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Board of Nursing  \nWes Moore, Governor ∙ Aruna Miller, Lt. Governor ∙ Meena Seshamani, M.D., Ph.D., Secretary  \nInitial Application for CNA-I Certification  \nNursing Assistant Certification Program  \nLast Name:  First:   Middle:  Home Address: Street:  City:   State:   Zip Code:  Home Phone:  Cell:  Personal Email Address:   \nBusiness Address (optional):  \nStreet:   \nCity:  State:  Zip Code:   \nBusiness Phone (optional):   \nBusiness Email Address  \n(optional) :   \nGender:   Male   Female   Other/ Unspecified (Select One)  \nSocial Security or Individual Tax ID Number:   \nDate of Birth: / /   \nMonth Day Year  \nMarital Status: (Circle One) Single Married Separated Divorced Widowed  \nEthnicity: Are you of Hispanic or Latino origin? (Select One)   YES   NO  \nRace: Multiracial respondents may select all applicable racial categories below:   American Indian or Alaska Native  \n  Asian  \nBlack or African American  \n___  \nNative Hawaiian or Other Pacific Islander  \n___  \n  White / Caucasian  \n4140 Patterson Avenue-Baltimore, Maryland 21215-2254  \nToll Free: 1 (888) 202 – 9861 • Phone: (410) 585 – 1900 • TTY/TDD: 1 (800) 735 – 2258  \n[www.health.maryland.gov/mbon](www.health.maryland.gov/mbon)  \nInterpreter Services are available upon request.  \nEducation:  \n1. Did you successfully complete a nursing assistant training program or acute care nursing assistant training program within the last 24 months?   Yes   No  \nIf you answered yes, complete the following:  \nName and Location of Nursing Assistant Training Program/Acute Care Nursing Assistant Nursing Training Program:  \nDate Training Program Completed:   \n**DOCUMENTATION REQUIRED: Attach a copy of your certificate of completion. In addition, have the last page of this application completed by the program coordinator or faculty of the training program you completed.  \n2. Did you complete a portion of an approved nursing education program that meets the requirements of a nursing assistant training program set by the Board within the last 24 months?   Yes   No  \nIf you answered yes, complete the following:  \nName and Location of Nursing Education Program:  \n____________________________________________________________________________________________________________  \n____________________________________________________________________________________________________________  \nDate Portion of Nursing Education Program Was Completed:    \n**DOCUMENTATION REQUIRED:  \n• For nursing students and graduates educated in the United States, order and email an of􀏐icial transcript from Parchment or Clearing House demonstrating successful completion of a portion of an approved nursing education program that meets the requirements of a nursing assistant [training program approved by the Board to: mbon.cnatranscripts@maryland.gov](training program approved by the Board to: mbon.cnatranscripts@maryland.gov)  \n• For foreign-educated nursing graduates, arrange for a Board-approved vendor (currently TruMerit) to evaluate your foreign transcript and submit a copy of that evaluation to the Board [to](to mdbon.nbexam@maryland.gov)[ ](to mdbon.nbexam@maryland.gov)[mdbon.nbexam@maryland.gov](to mdbon.nbexam@maryland.gov)  \n3. Did you successfully complete service member training and education that is substantially equivalent to a nursing assistant training program approved by the Board?   Yes   No  \n**DOCUMENTATION REQUIRED: Attach documentation demonstrating successful completion of service member training and education that is substantially equivalent to a nursing assistant training program approved by the Board.  \nBackground:  \n4. Have you ever been convicted of or pleaded guilty or nolo contendere (this includes a guilty plea for which a PBJ was received) to a misdemeanor?  \n  Yes   No  \n5. Have you ever been convicted of or pleaded guilty or nolo contendere (this includes a guilty plea for which a PBJ was received) to a felony?  \n  Yes   No  \n6. Has there ever been any disciplinary action taken against your li","cbCaivnNJp4ttdvp","https://ap.wps.com/l/cbCaivnNJp4ttdvp","pdf",447896,"English","# Initial Application for CNA-I Certification\n## Applicant Information\n## Education and Training Requirements\n## Background and Disclosure Questions\n## Signature","[{\"question\":\"What information does the CNA-I initial application collect from the applicant?\",\"answer\":\"It collects the applicant’s name, home and (optional) business contact details, gender, Social Security/individual tax ID, date of birth, marital status, and ethnicity and race selections.\"},{\"question\":\"What documentation is required for education or training completed within the last 24 months?\",\"answer\":\"For completed training, a copy of the certificate of completion is required, and the last page of the application must be completed by the program coordinator or faculty. For partial approved nursing education, applicants must provide official transcripts (including via specified methods) or a Board-approved foreign transcript evaluation.\"},{\"question\":\"What must applicants provide if they answer “Yes” to background or disciplinary questions?\",\"answer\":\"Applicants must submit a detailed letter of explanation and official certified/true-test copies of relevant court documents for misdemeanor or felony questions, plus character reference letters. For licensing discipline and abuse/neglect/misappropriation, they must provide detailed explanations and official copies of regulatory or related documentation/orders.\"}]","Initial Application for CNA-I Certification - Nursing Assistant Certification Program | PDF"]