EmailMeForm
Clackamas Nursing Assistant Training Application
First Name
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Last Name
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Street Address
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City and State
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Zip Code
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Email
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Phone
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How do you prefer to be contacted
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Yes
No
I will respond to text messages
I will respond to Email messages
I will respond to voice or voicemail
Please select the class dates you wish to attend.
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Class #34 - Jun 26 through Aug 10, 2023 -This class is currently filled. Future applicants will be placed on a wait list
Class #35 - Aug 21 through Sep 19, 2023
Class #36 - Oct 2 through Oct 31, 2023
Class #37 - Nov 13 through Dec 12, 2023
Please enter any questions or comments you may have:
You MUST answer the following questions:
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Yes
No
I understand that completing this application does not guarantee me admission into the program.
I understand that I will be asked to submit to a drug screen.
I understand that I must submit to a criminal background check by a vendor that meets the requirements of the Oregon Health Authority.
I am able to speak, read, write, and understand the English language.
I understand that I must complete the Basic Life Support CPR course, which is not included in the tuition.
I understand that I must provide proof of at least two (2) doses of COVID-19 vaccine.
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