Nursing Assistant Registration Application

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Nursing Assistant Registration Application PacketContents:1. 667-025 ......Contents List/SSN Information/Mailing page2. 667-029 ...... Application Instructions Checklist ........................................ ........3 pages3. 667-001 ...... Nursing Assistant Registration Application .................................4 pages4. 667-038 ......Out-of-State Credential Verification Form .....................................1 page5. RCW/WAC and Online Website Links ........................................ ......................1 pageImportant Social Security Number Information:If you have a Social Security Number, the law requires you to disclose it on your Application for a professional or occupational license.

transcript information. • Verification of Military Experience and Training (VMET) or DD Form 2586. See the DoDTAP website. • If applicable, application for the Evaluation of Learning Experiences During Military Service (DD Form 295). See the Military Resources website. DOH 667-029 September 2021 Page 3 of 3

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