Nurse Aide Reporting Form
The following information needs to submitted by July 15, 2021. Also, by this date testing results for all students should be entered into PeopleSoft. The number of students trained and your first time test taker pass rate will be mined directly from PeopleSoft. You will not be asked to supply that information in this report.
You are able to add/edit this report throughout the year. Once you complete the survey you will receive a link that allows you to come back to your data.
Please contact Denise Welch at denise.welch@kctcs.edu if you experience any difficulty or have any questions concerning this report.
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2. Please enter your training provider approval number(s):
4. RN Primary Instructor Information
Please feel free to enter any comments, suggestions, feedback, or additional evaluator/instructor/clinical site information in the space below.
10. Please electronically sign acknowledging accurate completion of this form. *This question is required.