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Nurse Aide Enrollment Application

Apply for the Nurse Aide Training course at Hawaii Healthcare School. Complete the form below to begin your enrollment.

Personal Information

Please provide your legal name exactly as it should appear on your certificate.

Emergency Contact

Provide someone we can reach in an emergency during class hours.

Course & Preferences

A $60 cancellation fee applies if you withdraw fewer than 3 business days before class starts.

Language Acknowledgment

Please read the following carefully before proceeding.

Hawaii Healthcare School — Nurse Aide class is an English based class with Japanese translation. Therefore, prospective students are required to have working comprehension of English (i.e. speaking, reading, writing, listening, etc.). Especially, if you plan to take the State of Hawaii certification test.

It is Not a 100% Japanese Nurse Aide class.


ハワイ ヘルスケア スクール — ナースエイドクラスは基本英語のクラスとなりますが、日本語のお手伝いが付きます。従いまして、このコースへの入学希望者は最低限の基本的な英語の読解力等が必要となります(たとえば、スピーキング、リーディング、ライティング、リスニングなどです)。特にハワイ州のCNA受験を考えている方は上記の能力が必要となります。

このコースは100%日本語のナースエイドクラスではありません。

Agreement & Signature

Please read the enrollment agreement carefully and sign below.

Agreement is binding: This agreement will be binding only when it has been fully completed, signed and dated by the student and an authorized representative of the school prior to the time instruction begins.

Changes in the agreement: Any changes in the agreement will not be binding on either the student or the school unless such changes are acknowledged in writing by an authorized representative of the school and by the student. We reserve the right to cancel classes for any reason or postpone classes due to insufficient enrollment. Every effort will be made to notify you of a cancelled class well in advance. If we cancel a class, you will receive a full refund of the class fees paid. In the event that you decide to withdraw, a refund may be given if a written or personal cancellation is received at least 3 working days prior to start of class. No refund granted after. Telephone cancellation is not accepted. There is a $60.00 cancellation fee to cover administrative costs and returned book.

Effective date of acceptance: I hereby agree to abide by the conditions set forth herein. I declare that I am 18 years or older, a high school graduate, and have no criminal record.

Deposit: A deposit of $300.00 is required at time of registration. The remaining balance is due before the first day of class.

Type your full legal name to certify: "I have no history of conviction of any felony, such as theft, abuse, assault, neglect, or drug use."

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