MT APIN Preceptor Course: September Cohort Registration Question Title * 1. Name Question Title * 2. Credential (RN, APRN, etc.) Question Title * 3. Education (ASN, BSN, Masters, Doctorate) Question Title * 4. Email Question Title * 5. Phone Question Title * 6. What healthcare organization are you a part of? Question Title * 7. What is your position (job)? Question Title * 8. Are you currently a preceptor? Yes No Other (please specify) Question Title * 9. What school are you affiliated with as a preceptor? Question Title * 10. What type of individual are you currently precepting? RN-BSN Student BSN Student ASN Student Master’s Student (CNL) Doctoral Student (DNP) New Graduate New Employee Done