Apply for Nurse Aide Training | Jordan Prestige Academy

First name

Last name

Birthday

Month

Day

Year

Phone

Email

Address

Highest Level of Education Completed

Preferred Class Schedule

Days

Evening/Weekends

Next Available

1. Are you able to read, write and communicate in English?

Yes

No

2. Are you able to perform the essential functions of a nurse aide, with or without reasonable accommodation?

Yes

No

3. Are you willing to complete all required admission documentation and screenings, including a required criminal background check?

Yes

No

4. Preferred Method of Contact

Text Message

Phone Call

Email

No Option

I agree to receive calls and text messages from Jordan Prestige Academy regarding my application, enrollment, class scheduling, and related school communications at the phone number I provided. Message and data rates may apply. I understand that I may opt out of text messages at any time.

5. How did you hear about us?

Applicant Certification

I certify that the information provided in this application is true and complete to the best of my knowledge. I understand that submitting this application does not guarantee acceptance or enrollment into Jordan Prestige Academy.

I have read and agree to the Applicant Certification above.

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Application Date

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