Enrollment Pre-Enrollment Form Please enter your information as it appears on your driver's license or government issued ID. All enrollment paperwork must be completed before you start class. You are always welcome to enroll in person. We're open Monday-Thursday 9AM-8PM. <!--onload="if(submitted){document.getElementById('successMessage').style.display='block';}" frameborder="0">--> <!--onload="if(submitted){document.getElementById('successMessage').style.display='block';}" frameborder="0">--> C/LNA CPR 1st-Aid Caregiver First Name Last Name Middle Name or Initial Street Address (ex: 8900 North Central) City Zip Phone (ex: (555)555-5555) Email Birthdate (MM/DD/YYYY, must be above age 16) Course Start Date (please see the CNA/LNA course calendar or contact us for start dates) Course Time - Course time - Day Evening Payment amount (optional) Please come in to setup payment plans or pay in person - Initial payment - Enrollment Fee Only ($300) Enrollment + Full Tuition ($1250) Comments (optional) Submit To submit, please complete all fields and click the checkbox below.Payment options will appear if you wish to pay online. Enrollment Options Enrollment Only $300.00 USD Enrollment + Full Tuition $1,250.00 USD The AHA CPR course cost is $30. SCSN CNA students will receive an additional discount based on exam performance. First Name Last Name Email Course Date (please see the CPR course info) or contact us for dates. Course Time? - Course time - 10AM 2PM 6PM Phone (ex: (555)555-5555) Current CNA/LNA Student? - Current CNA/LNA student - YES NO Special Notes (optional) Sign Up To submit, please complete all fields and click the checkbox below.Payment options will appear if you wish to pay online. The AHA 1st Aid course cost is $30. SCSN CNA students will receive an additional discount based on exam performance. First Name Last Name Email Course Date (please see the 1st Aid course info) or contact us for dates. Course Time? - Course time - 10AM 2PM 6PM Phone (ex: (555)555-5555) Current CNA Student? - Current CNA Student - YES NO Special Notes (optional) Sign Up To submit, please complete all fields and click the checkbox below.Payment options will appear if you wish to pay online. Pay
Star Canyon School of Nursing