RAW2HHC – HHA Class Sign-Up Application

  • RAW2HHC – HHA Class Sign-Up Application

    Fill out this form to apply for the Home Health Aide class and review the terms and contact details.

  • Applicant Information

  • Date of Birth*
     - -
  • Format: (000) 000-0000.

  • Class Interest

  • Preferred Time of Day*
  • Best Contact Method*

  • Background / Experience

  • Do you have prior caregiving, HHA, CNA, DSP, or home care experience?*

  • Transportation / Availability

  • Do you have reliable transportation?*

  • Optional Uploads

  • Upload a File
    Drag and drop files here
    Choose a file
    Cancelof
  • Upload a File
    Drag and drop files here
    Choose a file
    Cancelof
  • Upload a File
    Drag and drop files here
    Choose a file
    Cancelof

  • Acknowledgment

  • Refund Policy

  • Ready and Willing 2 Help Healthcare LLC provides a full refund of tuition and mandatory fees if a student withdraws before the first day of class. A 75% refund is available during the first week of instruction. A 50% refund is available during the second week of instruction. No refund will be issued after 50% or more of the program has been completed. Refund requests must be submitted in writing. Approved refunds will be processed within 30 days. If Ready and Willing 2 Help Healthcare LLC cancels a program before the start date, students will receive a 100% refund of all tuition and mandatory fees paid.
  • Date*
     - -
  • Should be Empty: