CNA Student Registration Form

  • CNA Student Registration Form

    Provide your details, credentials, and signature to secure your registration for the Certified Nursing Assistant programs.

  • Student Information

  • The Workforce Board (the state agency that regulates this school) requires that we ask you for this information, by law (RCW 28C.10.050). Providing your social security number is voluntary. By law, the information you provide on this form cannot be given out by any state agency as public information. The Workforce Board will not disclose data to anyone except authorized Workforce Board employees or contractors working on specific research activities, who follow strict confidentiality procedures. This format follows the information required to be submitted by the school as part of the annual student data report.

  • Format: (000) 000-0000.
  • Date of Birth*
     - -
  • Race*
  • Are you Hispanic in origin?*
  • Sex*
  • Are you Disabled?*
  • Are you a military veteran?*
  • Employment Status*

  • Student Information

  • Are you 18 years of age or older?*
  • Are you able to pass a criminal background check?*
  • Are you Applying for HCA-CNA Bridge or CNA Traditional (3 Weeks) Program*

  • CNA Traditional Program

  • CNA Program Tuition & Payment Options.

    Total tuition is $950 (plus tax), which includes a non-refundable $50 registration fee. All tuition payments are non-refundable upon cancellation.

    Pay in Full: Total balance is due today.
    Payment Plan: First installment is due today, the remaining balance is due in 14 days, and a $20 Installment fee applies.
    Hold a Spot ($50): Pay just the $50 registration fee today to secure your seat. You will receive an email link to complete your full payment or payment plan, which must be finalized 10 days before class starts.

  • Choose your Start Date*
  • Are you making a full payment or payment plan?

  • HCA-CNA Bridge Program

  • HCA-CNA Bridge Program (Active WA HCA License Required)


    Tuition is $650 (plus tax), which includes a non-refundable $50 registration fee. There are no installment plans are available for this program.

    To Enroll Today: Full payment is due at registration.
    To Hold a Spot ($50): Pay the $50 registration fee today to secure your seat. You will receive an email link to complete your full payment, which must be finalized 10 days before class starts.

  • Choose your Start Date*

  • Admission Requirements

  • To enroll in the Nursing Assistant Certification (CNA) Program, students must meet the requirements and agree to provide required documents.

  • Final Step: Select Program and Make Payment.

  • Tuition Programs*

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    HCA-CNA Bridge Tuition (Full Payment). Full Payment for HCA-CNA Bridge Program (5 Days)
    HCA-CNA Bridge Tuition (Full Payment)

    Full Payment for HCA-CNA Bridge Program (5 Days)

    $650.00$650.00
      
    CNA/NAC Program Tuition (Full Payment). Full Payment for CNA Traditional Program (3 Weeks)
    CNA/NAC Program Tuition (Full Payment)

    Full Payment for CNA Traditional Program (3 Weeks)

    $950.00$950.00
      
    Registration Fee - Hold Spot in Class. This fee guarantees a class spot for you. This payment is due today. A payment link with the balance will be included in the confirmation email. This will be due 10 days before start of class. If you cancel the class, the tuition fee is not refunded.
    Registration Fee - Hold Spot in Class

    This fee guarantees a class spot for you. This payment is due today.  A payment link with the balance will be included in the confirmation email. This will be due 10 days before start of class.


    If you cancel the class, the tuition fee is not refunded.

    $50.00$50.00
      
    Subtotal
    $0.00$0.00
    Tax
    $0.00$0.00
    Total
    $0.00$0.00

    Payment Methods

    creditcard
    After submitting the form, you will be redirected to Apple Pay to complete the payment.
    After submitting the form, you will be redirected to Google Pay to complete the payment.

  • Electronic Signature Requirements

    By checking the boxes below, I certify that I have read & I do meet the requirements of the program and that the information provided is accurate and true to my knowledge.
  • Date of Signature - Must be on the same date you are completing this form.*
     - -
  • Should be Empty: