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NAACLS Program Official Form with Payment

Program Official Form

Please note this form is not intended for:

- Individuals associated with a new program applying for NAACLS Accreditation. For initial programs, please follow the instructions in the NAACLS Accreditation Application Packet.

 - Individuals who have been approved by NAACLS in the past. If this is the case, please complete the demographic pages of the Program Official Approval Form,  the NAACLS Approval Letter, a current CV, and a narrative explaining the changes (e.g., assuming the role of another NAACLS Accredited program at this institution or another institution). A single PDF document of the aforementioned documents should be submitted to POForms@naacls.org. Since the applicant has been approved previously, the application fee is waived.
Prior to completing this form, please complete all information in one of the linked form below. Please consult the NAACLS Standards and the NAACLS Standards Compliance Guide when completing the document.

We will request you upload the form and all attachments in one PDF below.
1. The applicant is applying for the following program(s) type (check all that apply) *This question is required.
Space Cell BMSCGDCLSDMSHTHTLMLAMLMMLSMLTPath APBTPHM
.
2. Sponsor / Institution Information
3. Information regarding the individual completing this form:
The individual completing this form is the program official looking to be approved via this form
Your role at the sponsoring institution/program:
Contact information if individual completing form is not the applicant
Space Cell PrefixFirst NameMiddle InitialLast NameCredentials
-
This question requires a valid email address.
This question requires a valid number format.
This question requires a valid number format.
4. Applicant is applying for one of the following: *This question is required.
  • Permanent status
  • Temporary status
5. Name and credentials of program official applicant
Name *This question is required.
Space Cell PrefixFirst NameMiddle InitialLast NameCredentials
-
This question requires a valid email address.
This question requires a valid number format.
This question requires a valid number format.
6. Other names the applicant's transcripts, certifications, etc may come through as :
(to allow NAACLS to tie the paperwork to this submission)
Space Cell PrefixFirst NameMiddle InitialLast NameCredentials
1
2
3
7. Upload an approval form and related documentation below.  Please condense all files into one (1) pdf.
If you have not yet downloaded the application form, please do so here:
Program Official Approval Form

We have heard from some users that this button is taking multiple clicks to function.
Please click several times if it does not open immediately.  We are working with support. Thank you. *This question is required.
8. If required for position (see form), applicant is ASCP BOC certified in the appropriate discipline and has primary source verification sent to POForms@naacls.org.

Verification by ASCP BOC; use ascp.org and click on “verification"
9. If required for position, applicant's official college transcript for highest degree earned will be sent electronically to NAACLS from the primary source (POForms@naacls.org).
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