Clinical Research Nurse Certification Application
It is the responsibility of the individual CRN to notify the Clinical Research Nurse Certification Council (CRNCC) of change in their name and/or address. CRNCC is not responsible for notices that fail to reach the Clinical Research Nurse (CRN).
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*Enter Retired if Applicable for RN license or country equivalent
My submission affirms that all information submitted for the purpose of certification or recertification consideration is accurate and complete. It is my understanding that certification and recertification is based solely on the submitted materials and will be denied for any of the following reasons:
Falsification of application; Misrepresentation; Failure to meet criteria for contact hours/points per policy; Failure to provide requested information/documentation requested during audit; Failure to meet experiential requirement; Lack of current unencumbered RN license; Failure to submit appropriate fees; Failure to apply by deadline.
Upload your supporting documentation:
Please note underlined items below are live links to the document template should you need to download for submission.
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Continuing Education Documentation Record *excel sheet
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Continuing Education Certificates *ensure you include ALL certificates with submission.
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Resume (Not required for renewal) *see Appendix E of Handbook
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Exemplar (Not required for renewal) *see section 3.4 and Appendix F of Handbook
If applicable, include:
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CRN Preceptor Form
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CRN Mentorship Form
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​Supporting Documentation
All fees are non-refundable and non-transferable.