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Clackamas Nursing Assistant Training Application
Please review the costs, schedule, and policies prior to completing an application.
First Name
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Last Name
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Street Address
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City
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State
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Zip Code
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Email
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Phone
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Checkbox Grid
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Yes
No
Is English your primary language?
If NO, what is your primary language?
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 #47 - Jun 16 - Jul 16, 2025
Class #48 - Jul 28 - Aug 26, 2025
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 and a background check.
I am able to speak, read, write, and understand the English language.
I understand that, if selected for the class, I must attend every scheduled day. If I must miss a classroom/lab day due to an emergency, I will be required to make up the missed time at a rate of $30 per hour.
I understand that there is no make-up day for the clinical portion of the course.
I understand that I must complete the Basic Life Support CPR course, which is not included in the tuition.
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