APPLICATION

Provide a letter of recommendation and a resume with your application.
Program details at https://healthcareaccessnow.org/programs/community-health-worker-job-training/
Admittance to the program requires an online career assessment and a copy of your driver's license and high school diploma or GED. Look for directions to take the career assessment after you submit this application.

Question Title

* 1. Select one session.

Days/Time: Mondays and Fridays, 9 a.m. to 5 p.m.

Question Title

* 2. How did you hear about the HCAN CHW Certification Training Program?

Question Title

* 3. Name

Question Title

* 4. Contact Information

Question Title

* 5. Personal Data

Question Title

* 6. Military Service - have you ever served or are you now serving in the military?

Question Title

* 7. Emergency Contact

Question Title

* 8. Academic Information

Question Title

* 9. Employment History - Current or Most Recent

Question Title

* 10. Employment History - Job 2

Question Title

* 11. Employment History - Job 3

Question Title

* 12. Employment History - Job 4

Question Title

* 13. Personal Statement
Why are you interested in going through this program and what are your expectations?
300 words or less

Question Title

* 14. THREE Professional/Personal References (cannot be family members)

Question Title

* 16. INVOICE - If your employer is paying the tuition, provide contact information for the person that should receive the invoice.

Question Title

* 17. Let us know here if there is anything else you wish to share.

Question Title

* 18. Upload copy of letter of recommendation.

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
Choose File

Question Title

* 19. Upload copy of your resume.

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
Choose File
Your application is complete upon receipt of the application fee. Check your email for the payment link, emailed in 1-2 business days, or go to the healthcareaccessnow.org webpage to pay now with a credit card online or with a cashier's or employer's check (personal checks not accepted).

When you click 'APPLY' your application will be submitted. Thank you!!

T