Certified Nurse Aide Employer Recruitment Program Initial Attestation

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Please login below using the Registrant's information to complete the employment attestation. Contact the Registry office if you have any questions about the form.


Registrant's Last Name	Registrant's last 4 digits of SSN	Registrant's Date of Birth

North Dakota Department of Health and Human Services
1720 Burlington Drive, Suite A
Bismarck N.D. 58504-7736