CAREER DEVELOPMENT PROGRAM APPLICATION FORM

Northwest Community Center is organizing a 20-week Medical Assistant certification course in Spring/Summer 2026.

The class will be a hybrid class, both online and in-person. The committment for this class is around 15-18 hours per week. In-person classes will be on Monday-Thursday from 9:00am-12:00pm. Classes will also take place two Saturdays each month from 9:00am-1:00pm. The class sessions will be free for all students.

Requirements for the Certified Medical Assistant class:

English proficiency (ESL Level 5/6) - all applicants will be tested.
Ability to work, including necessary work-ready documents.

Name*

First NameLast Name

Phone Number*

Please enter a valid phone number.

Email*

example@example.com

Which class would you like to apply for?*

Customer Services & SalesCertified Medical Assistant

Do you have a refugee, immigrant or asylee legal status?*

RefugeeImmigrantAsylum seeker

Are you legally able to work in the United States?*

YesNo

Are you able to speak English?*

YesNo

What is your proficiency level of English?*

BeginnerUpper BeginnerIntermediateAdvanced

Are you able to read in English?*

YesNo

Are you able to write in English?*

YesNo

Do you possess a basic level of proficiency in Math? (adding, subtracting, multiplication and dividing numbers)? I am comfortable with using a calculator.*

Yes, I have a basic level of MathNo, I do not know mathI am comfortable using a calculatorNo, I do not know how to use a calculator