LPN to RN Bridage Verification of Licensed Practical Nursing Work Experience 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your name, license number, email, and phone number in the designated fields. Ensure accuracy as this information is crucial for verification.
3. Fill in the employer's name and address where you earned your hours. This section is vital for confirming your work experience.
4. Indicate the total number of work experience hours and your job title. Be precise to meet the application requirements.
5. Provide a detailed description of your job duties. Use clear language to outline your responsibilities as an LPN.
6. Sign and date the form at the bottom. Your signature authorizes Lane Community College to verify the provided information.
7. Instruct your employer to complete their section, including their signature and contact details, ensuring they seal it before returning it to you.

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