NCIT Supervisor Certification

This form must be completed by the participant's direct supervisor to verify eligibility for the National Certified Investigator & Inspector Training (NCIT) certification. Please complete all required fields and provide your digital signature to certify the information below.

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Participant Information

First Name * First name is required.

Last Name * Last name is required.

Program Attended * Please select the program the participant attended.

Employment & Experience

Please note that NCIT certification is granted only to participants who have (1) attended a CLEAR NCIT Basic program and completed all required components, (2) passed the NCIT Basic Final Exam, (3) been employed for a minimum of one year in a regulatory investigations capacity, and (4) paid all required program fees in full. This form certifies requirement (3) only.

Current Agency / Organization * Current agency is required.

Participant's Hire Date * Date participant began employment at your agency. Hire date is required.

Participant's Job Title * Job title is required.

Does the participant have prior service as a regulatory investigator at another agency that would fulfill the one-year work experience requirement? If so, please provide the details below.

Prior Agency Name * Prior agency name is required.

Participant's Job Title at Prior Agency * Job title at prior agency is required.

Start Date * Start date is required.

End Date * End date is required.

Supervisor Information

Supervisor Full Name * Supervisor name is required.

Title / Position * Title is required.

Agency / Organization * Agency is required.

Email Address * A valid email address is required.

Phone Number

Certification & Signature

I, the undersigned supervisor, hereby certify that the participant named above has served as a regulatory investigator or inspector for a minimum of one (1) cumulative year, either at the current agency (based on hire date) or through a combination of current and prior regulatory agency experience as indicated above. I certify that the information provided in this form is accurate and complete to the best of my knowledge.

Supervisor Signature *

Please provide your signature.

Certification Submitted

Thank you. Your certification has been received and will be reviewed by CLEAR Learning staff. You will be contacted if any additional information is needed.