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
CourseDescriptionUnitsCompletedIn ProgressComments
NRA 150A Certified Nurse Assistant6.0   

    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



Date: ________________________   By: ____________________________________________