Evaluation Worksheet for Certificate		Certified Nurse Assistant
SID:	________________________________	Skills Certificate - 5076
		Effective: Fall 2017
		Health Sciences
Name:	________________________________	(707) 522-2874

REQUIREMENTS: Complete 6.0 units Certified Nurse Assistant Requirements - complete 6.0 units Course Description Units Completed In Progress Comments NRA 150A  Certified Nurse Assistant 6.0

	Evaluation worksheet completed upon receipt of Transfer Credit Evaluation form. Includes credit from other institutions only received to date.
	Evaluation worksheet completed for ________________________________. Includes all SRJC and transfer credit received to date.

Units completed:    __________ Units in progress:    __________ Total:    __________

Requirements Completed     Pending (work in progress)     Requirements Not Completed

Comments

Date: ________________________   By: ____________________________________________