Resident/Student/Academic Affiliation
Beckley Nurse Residency Program
Beckley VAMC Nurse Residency Program Application PacketCollege and Universities
Welcome to Beckley VAMC! We look forward to build an academic affiliation with you.
There are a couple of steps to be in place before a student/resident can be scheduled for clinical rotations. Please reach out to the Education staff at extension 4659, 4576, or 2016 for any questions.
1. Affiliation Agreements
- Prior to any training at the Beckley VAMC a current Affiliation Agreement with the accredited program must be on file. Please contact Beckley VAMC Education staff for the document templates
2. Trainee Qualification and Certification Verification Letter (TQCVL)
- This template cannot be altered and needs to be copied onto your School Letterhead.
- Must be filled out 30 days prior to the first day of clinical rotation or beginning of the academic year with the schools internal signature.
- Any new additional students scheduled for clinical rotations within the academic year, must have a new TQCVL and student list.
TQCVL template
TQCVL Student List
https://www.sss.gov/ Selective Service Link for validation
Am I an eligible student?
3. Student Onboarding
- Students are to complete the provided forms at a minimal 30 days prior to their first day of clinical rotation.
- Forms are provided below.
- Complete Mandatory Training.
- Initiate fingerprinting/background verification
Application of Health Professions Trainees
Declaration for federal Employment (OF306)
Health Professions Trainee Random Drug Testing
WOC Stipend Appointment Letter - GVMC Residents Only
** Influenza Form: Only need to complete if you declined the flu vaccine. You will be expected to wear a face mask throughout the influenza season while on campus.
Helpful tips for onboarding process:
- When filling out the Application for Health Professions Trainees, be sure to sign as the applicant and the appointee.
- You do not have to get the Standard Form 61, Appointment Affidavit notarized. We have a notary here. Please make sure to fill it out and sign it.
Step 2: Complete Mandatory Training- Talent Management System
This must be completed prior to your first day of clinical rotation.
You will receive an email on the account information and log in.
If you have any questions, please contact jason.goodman@va.gov or at 304-255-2121 extension 1950.
Step 3: Personal Identity Verification- Fingerprinting
- Fingerprinting is conducted in the PIV office (1B-110). Monday- Friday 8:30am- 3:30pm except for Federal Holidays.
Bring Two forms of Identification (Driver's License, Social Security Card, passport, or birth certificate). https://www.beckley.va.gov/docs/PIV.pdf
Fingerprints can be taken at any Department of Veterans Affairs VAMC as long as you call to schedule an appointment.
Locations and phone numbers can be found at locations.
It is very important to tell them that the fingerprint results need to be sent to the Beckley VAMC and provide them with these two numbers:
SON-1015
SOI-VA61
Step 4: Student Exit/Perception Survey and Clearance Form
The VA Trainee Satisfaction Survey asks you to rate various aspects of your training experience.
This online anonymous survey takes approximately five minutes to complete.
Step 5: Clearance from Beckley VAMC - On the last week of your rotation, please reporter to Building 6 (Education Building).

















