Student Submission Portal

Contact information

First name

Last name

Email

Phone

Multi-line address

Country/Region

Address

City

Zip / Postal code

Enter your official CNA license number issued by CDPH

Upload Your California State ID or Driver’s License*

Please ensure your ID is legible and includes your full name and photo. This is required for identity verification and enrollment purposes.

Upload Your Social Security Card*

Upload a clear scan or photo of your Social Security Card. Please ensure your Social Security Number is fully visible. This is required to verify your eligibility for the course

Upload Your COVID-19 Vaccination Card*

Please upload a clear photo or scan of your COVID-19 Vaccination Card. This is required for CNA clinical training at Skilled Nursing Facilities to ensure safety.

Upload Your Headshot Photo

Upload a clear, professional headshot photo with good lighting and a plain background. This will be used for your student ID badge. Avoid selfies or photos with filters.

Upload Live Scan Fingerprinting Form

Please upload a clear photo or scan of your Live Scan Form

Physical Examination Form

Please upload a clear photo or scan of your Physical Examination Form

Upload CDPH 283 D (PDF) - HHA Initial application

Please upload your completed CDPH 283 D form (Home Health Aide Application). This form is required by the California Department of Public Health to start the Nurse Assistant certification process.

Let us show you how easy it can be to save a life.

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Next CNA Class Starts July 14, 2025 — Reserve Your Seat Now

Student Submission Portal

Contact information

Let us show you how easy it can be to save a life.