EmailMeForm
Clackamas Nursing Assistant Training Application
First Name
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Last Name
*
Street Address
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City
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State
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Zip Code
*
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 #37 - Jan 8 through Feb 7, 2024
Class #38 - Feb 26 through Mar 26, 2024
Class #39 - Apr 15 through May 14, 2024
Class #40 - Jun 3 through Jul 3, 2024
Class #41 - Jul 22 through Aug 20, 2024
Class #42 - Sep 16 through Oct 16, 2024
Class #43 - Nov 4 through Dec 9, 2024
Please enter any questions or comments you may have:
You MUST answer the following questions:
*
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.
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.
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