Medication Aide Deposit ( 68 hour)

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$200.00

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$200 deposit is non-refundable

You will be dropped from the class if:

1. Your first payment is not received.

2. You miss any payments following your first payment. If this happens, you will not be eligible for a refund of any previous payments made.

Uniform: white scrub top - we provide you with one

Uniform : burgundy pants - student's responsibility

Requirements

Must be a Nurse Aide OR PCA graduate. We will not accept PCA certificates from other schools if we can not verify them (If you do not have either of these certifications ask us about our bridge program)

Pass 10- Panel Drug Test and Random Drug Test done @ DHEC and /or clinical site discretion
Pass criminal background check (no felony charges, no assault and battery charges)
Be at least 18 years old
A negative TB test report ( before the start of clinicals)
The ability to read and write English
All tattoos must be covered
Nails must be short with no artificial covering
No facial piercings
Only ear lobe piercings allowed
Long hair must be pulled back
No head scarves or wraps(unless for religious purposes), no caps or hats when in uniform

Student First Name *

Student Last Name *

Female or Male? *

Student Address *

Student Phone Number *

Student Email Address *

Where did you receive your PCA, NA, or CNA certificate? What year did you receive it? *

Have you ever been convicted of threatening another person, assault, battery, or theft? If so, we are unable to enroll you at this time *

Have you ever been convicted of a felony? If so, we are unable to enroll you at this time *

Student's Social Security Number ( for criminal background check) *

Student's date of birth( for criminal background check) *

Please type in the date of the class you are registering for (see class dates below) *

Scrub top size *

How did you hear about us? *

Why did you decide to enroll in this class? *

Please enter your initials to acknowledge you have read our policy regarding the refundable and non-refundable portion of your deposit and/or payment *

Please enter your initials to acknowledge you have read our program requirements regarding tattoos, facial and ear piercings , artificial nails and length of nails, and head scarves, head wraps, caps and hats *

* indicates a required field

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