WVW Academy — CHW Application
Enrollment is approval-only; submit your application for review and next-step instructions within a few business days.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Are you applying as an individual or through an employer/sponsor?
*
Please Select
Individual
Employer-Sponsored
Grant-Funded
Organization Name & Contact
Relevant Experience (if any) — background in community health, healthcare, or related work
Why are you interested in the CHW program?
Preferred Cohort
*
Please Select
August 4, 2026
Future Cohort — Notify Me
How did you hear about this program?
Please Select
Social Media
Referral/Word of Mouth
Employer
Email Newsletter
Web Search
Other
Submit Application
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