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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

Applications for Licensure as a Nursing Home Administrator are now accepted online. Click here to begin the online application process.

Application for Administrator-In-Training

Applications for Licensure as a Nursing Home Administrator-In-Training are now accepted online. 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

Application for Registration as a Preceptor

Applications for Registration as a Nursing Home Administrator Preceptor are now accepted online. Click here to begin the online application process.

Application for Reinstatement

Continuing Competency

 

 

Assisted Living Facility Administrator Forms:

ALF-AIT Education and Experience Matrix

ALA Application for Licensure

Applications for Initial Licensure and Endorsement as a Assisted Living Facility Administrator are now accepted online. Click here to begin the online application process.

ALA Application for Reinstatement

ALA Application for Administrator-in-Training

Applications for Initial Licensure as a Assisted Living Facility Administrator-in-Training are now accepted online. 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

ALA Application for an “Acting” Administrator-in-Training

ALA Application for Certification as a ALA Preceptor

Applications for Initial Certification as a Assisted Living Facility Administrator Preceptor are now accepted online. Click here to begin the online application process.

Continuing Competency

 

Other Forms

 

National Association of Long-Term Care Administrator Boards (NAB)

 

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.