Nutrition and Dietetics ReademyotNutrition Gh, andDietetcs VERIFICATION STATEMENT (See Guidelines on Reverse Side) | verify that the graduate indicated below entered and completed the requirements of the specified dietetics program ata time when the program was accredited by the Accreditation Council for Education in Nutrition and Dietetics (ACEND) of the Academy of Nutrition and Dietetics (formerly known as the Commission on Accreditation for Dietetics Education of the American Dietetic Association). Type of Program (select on: X Didactic Program in Dietetics" (DPD) DPD with an individualized Supervised Practice Pathway (ISP) Dietetic Internship Program Dietetics Program with an ISP for Doctoral- Coordinated Program Degree holders Dietetic Technician Program International Coordinated Program Graduate Being Veri Giménez Ana 7 Laura Last Name First Name ‘Middle Name/initial _ 13/18/1993 Pasini Maiden Name Graduate’s Date of Birth (DOB) ‘Mother's Maiden Name CAME P inal Signature of Program Director (Do not sign with black ink) Program Director: Rutgers, The State University of New Jersey Name of Institution Barbara L. Tangel, MS, RON 6904 Name “4 Digit CDR Program Code Number listed in the Registration Examination Handbook for Candidates) DPD. Director 26 Nichol Avenue, Davison Hall, room 229-b Title ‘Address Nutritional Sciences New Brunswick, NJ 08901-2882 Division/Department City/State/Zip 07/12/2016 05/15/2016 Date form signed by ProgramDirector Program Requirements Completed {on oF following the date of program completion) {DATE FORMAT: MM/OD/YYYY) (Graduate and Program Director: See Guidelines on Reverse Side) “This form should not be used to verify completion of Plan IV or other ADA-approved programs in existence before 1988. Graduates of Plan IV Programs must complete the current ACEND-accredited academic requirements in order to be issueda verification statement. oncademy of Nutrition and Dietetics, 2014 Revised 12/01/2014 a