Registration Requirements and Document Submission

STUDENT REGISTRATION CHEEK SHEET

Please Review and Submit the following Documents
STUDENT NAME
PROGRAM ENROLLED
APPLICATION DATE

MonthDayYear
Date
REQUIRED DOCUMENT CHECK SHEET
The following documents are required for enrollment into Scrubs Health & Training Center's training programs. Please submit the required documentation with the completed application to avoid delays in the enrollment process.

(Includes Background consent form, and drug Screening Consent)
COMPLETED ENROLLMENT AGREEMENT FORM
COPY OF SOCIAL SECURITY CARD
COPY OF VALID GOVERNMENT ISSUED PHOTO ID
COPY OF RECENT PHYSICAL
(Must have been completed within the last 12 months)
COPY OF RECENT TB TESTING RECORD
(Mantoux must have been completed within the last 12 months or Chest X-ray completed in the last 5 years)
COMPLETED BACKGROUND CHECK
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DATE

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Date
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