Form 1 Table 1

Nurse Anesthetist Traineeship (NAT) Program

Table 1 NAT forms

NAT Forms

OMB: 0915-0374

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Table 1 - NAT: Enrollment, Traineeship Support, Graduate, Graduates Supported and

Projected Data

Complete Table 1 summarizing student enrollment, trainee/ student support, graduates, graduates supported and projected student enrollment. Instructions for completing Table 1 are below.


Students

Total # of NAT Full-time Students Enrolled
(As of MM/DD/20XX)

Total # of NAT Students Supported
(MM/DD/20XX - MM/DD/20XX)

Total # of Graduates
(MM/DD/20XX-MM/DD/20XX)

Total # of NAT Graduates Supported
(MM/DD/20XX - MM/DD/20XX)

Projected Students by MM/DD/20XX

# Master’s Students in First 12 Months of Study






# Doctoral Students in First 12 Months of Study






# Master's Students Beyond First 12 Months of Study






# Doctoral Students Beyond First 12 Months of Study






OMB NO.: 0915-XXXX EXP. DATE: MM/DD/20XX

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