EmailMeForm
Clackamas Nursing Assistant Training Application
First Name
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Last Name
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Street Address 1
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Street Address 2
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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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 #28 - May 4 - POSTPONED due to COVID-19 outbreak
Class #29 - Jul 6 through Aug 18, 2020
If conditions improve, we MAY have a class in June. For now the July 6 class remains on the schedule, but may be delayed or postponed as virus conditions permit. Please check our web site for class news.
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 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 must complete the Healthcare Provider or Basic Life Support CPR course, which is not included in the tuition.
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