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Pre-Registration for MeritLife Academy Courses

Pre-Registration Form

Pre- Registration Form

$35.00

NURSE ASSISTANT TRAINING PRE REGISTRATION FORM

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Course Requirement

List of Requirements for Enrollment into the Nurse Aide Skills Course:

VALID Driver License or Gov’t issue ID ____Social Security Card ____

Immunizations:

Provide proof of the following

  • T DAP (within last 10 years)      

  • MMR (Measles, Mumps, Rubella)

  • Hepatitis B

  • Varicella

  • Bacterial Meningitis (if under 21)

  • NEGATIVE TB Test (within 1 year)

Proof of Education: _____

HS, GED, ATB, Home School Certificate, or College transcript

 

Certificate for CBT (computer-based training) _______

 

Signed Release for Criminal Background Check, DADs Employability and Nurse Aide Registry