Board of Long-Term Care Administrators
Forms & Applications
Please be aware that payments made in person to the Board office will not be processed until the next business day, with the exception of renewal payments received on the last day of the month.
Nursing Home Administrator Forms:
Application for Nursing Home Administrator Licensure
Click
here to begin the online application process.
Application for Nursing Home Administrator-In-Training
Click here to begin the online application process.
For a list of licensed Preceptors who volunteered their contact information be posted in a public directory, please click on the following link: Preceptor Directory
- Monthly Report for AIT
- Documentation of Completion Form
- Proposed AIT Program Training Plan/Domains of Practice
- Notice of Change of Status or Discontinuance
Application for Registration as a Preceptor
Click
here to begin the online application process.
Application for Reinstatement
Continuing Competency
- Continued Competency Activity and Assessment Form - Nursing Home Administrator (revised 10/2014)
- Continuing Education Form for Volunteer Practice
Assisted Living Facility Administrator Forms:
ALFA-Administrator-In-Ttraining (AIT) Education and Experience Matrix
ALFA Application for Licensure
Click here to begin the online application process.
ALFA Application for Reinstatement
- Assisted Living Facility Administrator Application for Reinstatement
- Application for Reinstatement as an Assisted Living Facility Administrator Preceptor
Application for ALF Administrator-in-Training (AIT)
Click here to begin the online application process.
For a list of licensed Preceptors who volunteered their contact information be posted in a public directory, please click on the following link: Preceptor Directory- Monthly Report of Assisted Living Facility Administrator-In-Training
- Completion of Assisted Living Facility Administrator-In-Training
- Proposed AIT Training Plan/Domains of Practice
- Notice of Change of Status or Discontinuance
Application for Certification as a ALFA Preceptor
Click here to begin the online application process.
Continuing Competency
- Continued Competency Activity and Assessment Form - Assisted Living Facility Administrator
- Continuing Education Form for Volunteer Practice
Other Forms
National Association of Long-Term Care Administrator Boards (NAB)
- Visit NAB’s website and register to take the NAB exam.
- Visit NAB's website to download a PDF or MSWord copy of their Candidate Handbook and register to take NAB.
- Visit NAB's website to download a PDF copy of their AIT Program Manual.
The above documents are in Microsoft Word format. If you do not have Microsoft Word, you can get the Microsoft® Word Viewer to view and print documents.