Beltca forms 2026

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The document is a Preceptor/Administrator-in-Training Agreement from the Nevada Board of Examiners for Long Term Care Administrators. It outlines the responsibilities of a preceptor and an Administrator-in-Training (AIT) who will undergo at least 1000 hours of training over a minimum of 20 weeks, as per state regulations. The agreement requires signatures from both parties and includes provisions for notifying the board of any changes in the arrangement.

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Click ‘Get Form’ to open the Preceptor/Administrator-in-Training Agreement in the editor.
Begin by entering the date at the top of the form. Ensure you write it clearly in the designated space.
In the first blank field, input your name as the Preceptor. This identifies you as the responsible party for training.
Next, specify the name of the Administrator-in-Training (AIT) in the corresponding field.
Fill in the facility name where training will occur, followed by its complete address including city, state, and zip code.
Indicate the commencement date of training in the provided section.
Both AIT and Preceptor must sign and print their names along with dates in their respective sections at the bottom of the form.
Finally, ensure that a representative from BELTCA reviews and accepts your agreement by signing and dating where indicated.

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